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.

"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

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

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

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