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#1
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16 weeks update
Yikes- my right hip is starting to go numb when I walk! It starts with an
icey, prickly feeling that goes from my hip to above my knee, on the right side, only. It happened for the first time today after I had ridden in a car for 45 minutes and then walked around for a couple of hours straight on my feet. It's uncomfortable and I hope it doesn't start happening all the time now, 16 weeks seems to early. I have an appointment next week and I've decided to start declining all these tests because of my insurance coverage. I am declining the AFP, for sure. I still wonder- is it a bad idea ot decline the glucose test when that comes up, if I'm not having any symptoms that could be sugar related? Also, groupB strep, that's something I really do need, right? That would put the baby at risk if I was positive and they didn't prepare, right? I'm sleeping pretty well actually......I'm feeling ok most of the time....but I do feel that pressure when I walk and discomfort from the old episiotomy area. That feels pretty bad and I fear I may not be able to walk well- its already stopped me from walking fast/fitness walking. Or jumping. Not that I'd be jumping anyway....but you know....I make sure not to bounce when I walk down stairs, etc. I'm not having much nausea although I have no appetite and I have not gained weight yet, I'm only 16 ww though....I didn't gain last time either until the end. |
#2
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16 weeks update
"beyond the pale" wrote in message
... Yikes- my right hip is starting to go numb when I walk! It starts with an icey, prickly feeling that goes from my hip to above my knee, on the right side, only. It happened for the first time today after I had ridden in a car for 45 minutes and then walked around for a couple of hours straight on my feet. It's uncomfortable and I hope it doesn't start happening all the time now, 16 weeks seems to early. I'm sorry that your hip is hurting, and hope that it doesn't happen all the time. I have an appointment next week and I've decided to start declining all these tests because of my insurance coverage. I am declining the AFP, for sure. I still wonder- is it a bad idea ot decline the glucose test when that comes up, if I'm not having any symptoms that could be sugar related? Also, groupB strep, that's something I really do need, right? That would put the baby at risk if I was positive and they didn't prepare, right? Personally speaking, part of my decision on what tests to take or not take if my insurance didn't cover it would be the costs to me. If a test is cheap, and useful, then I'd pay for it. So before deciding about the glucose tolerance test, I'd want to know how much it cost. I don't know if you could have GD if you don't have symptoms, because I know little about it. But, I do know several people who barely failed their 1 hour test, and then were required to take the 3 hour test, which they then passed or failed. So another good question would be what would the treatment be if you failed the test, and by how much? Also, keep in mind, that if you fail the one hour test, then you sort of *have* to take the 3 hour test. And if you don't at that point, again, what would the options be for "treatment." Finally, in terms of the GroupB Strep, if you don't take the test, they can just treat you as though you DO have it, which means antibiotics during labor, which isn't a big deal. But, you should ask your insurance if they will pay for the antibiotics, because if not, it may be cheaper to have the test and be negative, then to be assumed positive and have to take repeated courses of antibiotics over 24-48 hours, you know? And, it's always possible that your insurance may pay for the antibiotics if you test positive and need them, but not if you don't test at all and they are just a precaution...so it's worth checking on. I have to say, as much as I hate insurance issues, your insurance is crap. : P -- Jamie Earth Angels: Taylor Marlys -- 01/03/03 Addison Grace -- 09/30/04 |
#3
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16 weeks update
beyond the pale wrote:
I have an appointment next week and I've decided to start declining all these tests because of my insurance coverage. I am declining the AFP, for sure. I still wonder- is it a bad idea ot decline the glucose test when that comes up, if I'm not having any symptoms that could be sugar related? You'll get different answers from different people. Some feel that it's important to test for and treat gestational diabetes. On the other hand, the evidence that screening improves outcomes isn't exactly overwhelming, as many of the studies don't weed out people with undiagnosed true diabetes (or have other complicating factors). There's also not overwhelming evidence that treating GD improves outcomes. It tends to make the babies a little smaller, but doesn't have as much impact on the things you'd actually care about (shoulder dystocia, c-section rates, neonatal hypoglycemia, etc.) Also, it's a screening test. So, if you fail the test, you still only know that you're in a higher risk pool and then you go on to take a more definitive test. The treatment for GD is either diet and exercise or diet and exercise plus insulin. Some feel that the evidence supporting the safety necessity of insulin for gestational diabetes isn't what it should be. If you weren't to take insulin, you would just be treating with diet and exercise, which, I suppose, you could choose to do regardless of any test results. If you don't get too restrictive with calories, a diabetic diet is generally quite healthy for pregnancy anyway. Also, groupB strep, that's something I really do need, right? That would put the baby at risk if I was positive and they didn't prepare, right? Well, you could argue for risk based management. With that, you get antibiotics if you have any risk factors (fever, preterm labor, membranes ruptured longer than 18 hours, maybe something else I'm forgetting). There have been studies showing that screening is a bit better, but one that I looked at only showed screening to be superior because in many cases, those who chose risk based management didn't follow through with antibiotics in every case where risk factors were detected. Personally, I felt comfortable declining both of those tests. I ate a healthy diet and knew I wasn't diabetic prior to pregnancy. I was comfortable with risk based management for GBS. YMMV. Best wishes, Ericka |
#4
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16 weeks update
beyond the pale wrote:
Yikes- my right hip is starting to go numb when I walk! It starts with an icey, prickly feeling that goes from my hip to above my knee, on the right side, only. It happened for the first time today after I had ridden in a car for 45 minutes and then walked around for a couple of hours straight on my feet. It's uncomfortable and I hope it doesn't start happening all the time now, 16 weeks seems to early. I remember first pregnancy having hip trouble at this stage, and thinking it was too early and I was doomed, in part I think it's about the stage where your centre of gravity does alter so your body has to get used to it, then hopefully deal with it better. The other thing for me was, that I had a muscle imbalance from one leg together, so some exercises helped. Does your insurance include coverage for physical therapy? It's not a miracle cure, but it can address some issues and hopefully decrease deterioration. Even if it isn't covered, it may still be worth the cost of an assessment, to see what is going on and if there are things that can help. Cheers Anne |
#5
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16 weeks update
I have an appointment next week and I've decided to start declining all these tests because of my insurance coverage. I am declining the AFP, for sure. I still wonder- is it a bad idea ot decline the glucose test when that comes up, if I'm not having any symptoms that could be sugar related? Also, groupB strep, that's something I really do need, right? That would put the baby at risk if I was positive and they didn't prepare, right? sorry a 2nd answer, forgot to do both in one! it may be reassuring to know that there are many developed countries which have better overall pregnancy/birth outcomes than the US (though that could be argued that the population profile of the US is unique, so not comparable), don't do either of these tests as routine. I think kmom has excellent info on gestational diabetes, see www.plus-size-pregnancy.org/gd/gdindex.htm and it's diagnosis and management is a very controversial subject. Being who I am, I'm comfortable not doing any screening tests, but that is knowing that I'm correct weight for height, young, no family history of either GD or type 2 diabetes etc. so I'm fairly confident that if I did screen positive and further tests were positive, that it would likely be barely positive and that I'm better off responding to my own body and observing if I get swings of energy levels etc. it's not scientific, but then nor is a lot of treatment for GD - there seems to be as many treatment protocols as there are doctors! GBS tests are not routine in the UK, so I never had to cross that bridge, there are companies offering it privately, but the majority of people using that kind of service seem to be people with a previous positive test, who would like the chance to screen negative and thus not be pressured for interventions and allow use of a low risk unit or have a homebirth, as the usual protocol seems to be to be treated as positive if a positive test has ever occured. It's a bit like GD in that the protocols surround this are not all the same or well proven, so you could fine one doctor giving antibiotics to all mums with waters broken over a certain length of time, but another recommending more in depth and extended observation of the newborn. A good coverage of this topic is at http://www.homebirth.org.uk/gbs.htm. It occured to me, does your insurance cover a midwife, even if it doesn't, the generally fixed fee of a midwife and the ability to discuss things from a range of angles and not taking a test test test approach, could be a happier place for you to be - a lot of doctors are going to have issues with you refusing lots of things and things are likely to go more smoothly if your care provider is someone who sees eye to eye with you. Cheers Anne |
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