My tale of woe

I had an appointment with the OB this week. In my OB practice, you don't necessarily see the same one all the time because of their philosophy - you never know who will be on call to deliver your baby. Being a cynic, I think it has more to do with malpractice rates, but that's me.

So I saw Dr S. I thought it would go well - young woman, seemingly nice ...I had high expectations. Especially after meeting with my primary OB who was the epitome of human kindness and patience.

I had a few concerns going into the appointment, especially after the very kind RN had gone through some of the bloodwork results with me (from my first appt, which no one called me about). It seemed that my thyroid (I'm hypothyroid anyway and take Synthroid) was on the low side - T3 was .33 and normal started at .35. My TSH was normal. Also, I was concerned about the ankle swelling and my ..er.... urinary leakage of late ... and most importantly, the risk of incompetent cervix as explained to me by Dr High Risk as I've had multiple d&cs and a recent miscarriage. All legit, right? Nothing too crazy, nothing too demanding?

The nice nurse put me in the sono room just in case there was a need for ultrasound. Being an infertility patient, you *know* at the REs there's always a need for ultrasound. I mean, really. But I wasn't in Oz any longer, so I wasn't sure what they were going to do. At the RE's, it was always "better safe than sorry". But I figured I'd be on my best behaviour and see what happened.

Dr S came in and mumbled her name at me. Asked me how I was doing and if I had concerns. I explained my few concerns/questions to her. She obviously hadn't had a chance to look at my chart and started leafing through: "Oh, your bloodwork all came back normal, even the Tay-Sachs." I told her what the RN had said about my thyroid. "Oh, that's nothing to worry about. You're just barely below normal".

Ping... I heard our relationship go from so-so to abysmal in .06 seconds.

At which point I shook my head. I mean ... if I'm below normal NOW ... what is she waiting for? For the level to drop precipitously? When I *know* that thyroid level is extremely important in fetal development/mental development?
But she had already moved on. "As for the incompetent cervix, we can check that when you have your amnio at week 16". At which point I (at week 13)again shook my head but this time words came out too. "I'm not comfortable with that" I said. "I'd rather get checked now and have some peace of mind, especially after my recent miscarriage". She looked at me and although she had good doctor-face on, I could tell she was annoyed.

So she (actually noticed I was allergic to latex)got the abdominal u/s thingie ready and started moving it to and fro on my belly in a joystickesque manner. Now I may be an RN, but u/s is NOT my specialty. If you don't tell me what I'm seeing - especially while moving the wand around - I honestly have no clue, all I see is an indiscriminate blob. So as she's about to zap the Morgons ...er ...anyway, I say to her very timidly "is there a heartbeat?"

And she looks at me and says "Can't you see it moving?? Guess if it's moving there's a heartbeat, huh?".
At which point I reached out and squeezed her neck rapidly while shaking her from side to side. She quietly slid down and expired. My first OB then walked in, looked at her there on the floor, said "good riddance" and continued the ultrasound. He explained everything with great kindness and understanding.

Oops sorry. Fantasy sequence. Pardon me.

And she looks at me and says "Can't you see it moving?? Guess if it's moving there's a heartbeat, huh?".
I said nothing. Because not only was I completely dumbfounded, there was no point. She didn't get it. She had no clue, even though it said "recurrent loss" on my chart. Even though my chart is already 2 inches thick and it's only my second visit. Even though I'm 39, have some obvious problems, am obviously distressed. Even though I'm human and have feelings. Yes, I was in my nurse's uniform but that shouldn't have made the least bit of difference.

Dr Shitty kept trying to zap Morgons on my belly. Finally she gave up trying to see my cervix through my abdomen and decided (Halleluyah! The chorus of angels that is my bladder sang!) to do a transvag, something she should have done from the beginning. She didn't even offer me a picture of my "obviously" moving baby. Bitch. I was burning inside.

Ah, the familiar cooter-cam. I was overjoyed. Well, not really but at least I knew what to do. Something about familiarity. Anyway, my cervix measured 5cm. So she said. I had to ask her if that was good to which she actually laughed (!!!)and told me that I was "above the curve" as normal was 2-4cm. She ok'd me for exercise as long as I keep my heartrate around 140, no higher. She also told me bluntly that there was nothing they could do about my urinary dribbling until after the baby is born. I kind of knew that, but ... oh well. I do Kegels semi-regularly. She then proceeded to argue with me about my blood type which was listed on the chart as O+, when I'm really O-. I have a relatively rare condition called a "weak D" which means that part of my rhesus (that's the + or - part) are positive and part is negative. She didn't actually believe me until I told her that I had received Rhogam post last d&c. Grrrrr.

And then I mentioned my weight to her. She got very upset with me because I've gained too much. I've gained approximately 16 lbs and I know it's not good. Yes, I was on a restricted calorie diet before I got pregnant and the minute I started eating normally the pounds leapt on. Yes, I have a very slow metabolism (thank you O thyroid gland) and normally put on weight easily. Yes, my thyroid may be low (thank you O Dr Shitty) which doesn't help. Yes, all I was able to keep down in first trimester were carbs which definitely pack on pounds in this girl.

My endocrinologist also read me the riot act about my weight gain after I went in to see her because of my lack of confidence (re:low thyroid reading)in Dr Shitty. She is very concerned. Dr Thyroid is also petite and tiny, which made me feel lovely. But she is kind and I at least feel that she gives a hoot. I need to go get punctured again for bloodwork because the OB's office faxed over the thyroid report that Dr Thyroid's office originally sent them in March, not the recent thyroid panel from the OB that I had asked them to send. *sigh*

But now I'm terrified about pre-eclampsia and losing my baby. Note I did not say "alleged baby". Yes, that means you, Stacy.
My blood pressure has measured anywhere from 104/65 to 120/84 which is fine so that helps my state of mind. I know I need to watch what I eat, start to exercise a bit, maybe cut out the carbs as much as possible. But I feel scared, intimidated, worried and a bit like a failure. I don't want to make this pregnancy a bad experience or harm my baby in any way. I want to do what's right. But I am terrified and frozen in place.

So ... if you have thoughts, advice, assvice, concerns, words of kindness ... please share them. And if you can, leave your email address so I can at least thank you.

And know one thing. My next OB appointment is NOT with Dr Shitty. Nor will it ever be again. *sigh* Wanna guess who's going to be on-call when/if I deliver? I just know it.