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#1
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My first appointment (17 weeks, 2 days along)
Today was my first doctor's appointment for this pregnancy. I had insurance
issues, when that finally worked out today was the first available appointment. with the nurse practitioner just to file paperwork and preliminary counseling. I've never been to this practice before, and to be honest I was settling for this practice instead of going with the birth center that had limited hours for appointments. This practice was in the new medical building near the hospital and it was so nice and open. They also didn't have a children policy like the last ob-gyn practice I went to. Juliet is allowed to go with me to all appointments (as long as she isn't one of those tyrannical children as they put it, lol) I have to admit this was a big relief because it means Dh can go with me to the appointments instead of waiting with Juliet in the parking lot. Juliet spent the time in the waiting room playing with the bead structure, and reorganizing all the stacks of magazines. (I had also brought a basket full of her various treasure trove of toys) I was called back by a really nice nurse who had another basket of toys in her office. Juliet had to show me all the toys and call Dada on the toy phone. (Dh had an emergency to take care of so he dropped us off for this one appointment) The nurse asked if I had any concerns, which really I don't. third pregnancy is sort of old hat for that kind of stuff. She then handed me an amazingly large packet of reading materials. The first was for the classes the hospital offers, I'll probably take Juliet to the little helper class. The second piece of the packet was a paper outlining a screening test for Cystic Fibrosis that isn't covered by most insurances and costs between $200 and $300 to get done. Another page covering medications okay for colds, flu and hay fever. I also received a booklet pamphlet about the expanded AFP for women under 35. Any opinions on this screening? They also gave me this really nifty spiral bound book covering pregnancy, childbirth, and infant care. It doesn't go into a lot of depth, but still really nifty! My favorite part is the list of recommended reading, which doesn't include "What to Expect" but does include other books that are awesome instead. Unlike my last pregnancy, this practice did not hand me any formula sponsored freebies! So, just from that above I'm really much more comfortable with this practice and it doesn't feel like settling for inferior care. I have to make up my mind on those tests above though by next appointment later this month. The nurse gave me the lab slip for the preliminary tests (blood and urine screening tests) and asked which doctor I would prefer. I mentioned how I know very little about any of them, but instinct said I should go with the one with small hands. She thought that was funny of course and recommended the female doctor in the practice. The nurse then mentioned that the next appointment would be the full exam with pelvic pap smear and ultrasound. =o/ I asked which kind of ultrasound it would be, in case I need to guzzle some water down. She said, "Oh, vaginal because it's the only one that would show the pregnancy this early." To which I reply, "Really? At seventeen weeks now, I would still need a vaginal ultrasound? I'm sorry but babies are allowed out of never never land, it's restricted access in the other direction!" =oP She didn't realize I was that far along, because she trusted my calculated due date and wasn't really thinking I suppose, lol. So the nurse suggested that would be good discussion for the appointment with the doctor. Then we went on our merry way across the building to the lab. Juliet was horrified and yet fascinated by the blood draw. Thus ended my first appointment at 17 weeks 2 days along in this pregnancy. My next appointment is on Tuesday March 22, when I will be 19 weeks and 2 days along. Laurel -- Birthmom to Bj 4-12-96 mommy to Juliet 4-13-02 and someone new due 8-14-05 |
#2
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Laurel-
It sounds like a pretty nice practice. Glad things went well! Kelly #4 2/15/05 "SuperEeyore" wrote in message ... Today was my first doctor's appointment for this pregnancy. I had insurance issues, when that finally worked out today was the first available appointment. with the nurse practitioner just to file paperwork and preliminary counseling. I've never been to this practice before, and to be honest I was settling for this practice instead of going with the birth center that had limited hours for appointments. This practice was in the new medical building near the hospital and it was so nice and open. They also didn't have a children policy like the last ob-gyn practice I went to. Juliet is allowed to go with me to all appointments (as long as she isn't one of those tyrannical children as they put it, lol) I have to admit this was a big relief because it means Dh can go with me to the appointments instead of waiting with Juliet in the parking lot. Juliet spent the time in the waiting room playing with the bead structure, and reorganizing all the stacks of magazines. (I had also brought a basket full of her various treasure trove of toys) I was called back by a really nice nurse who had another basket of toys in her office. Juliet had to show me all the toys and call Dada on the toy phone. (Dh had an emergency to take care of so he dropped us off for this one appointment) The nurse asked if I had any concerns, which really I don't. third pregnancy is sort of old hat for that kind of stuff. She then handed me an amazingly large packet of reading materials. The first was for the classes the hospital offers, I'll probably take Juliet to the little helper class. The second piece of the packet was a paper outlining a screening test for Cystic Fibrosis that isn't covered by most insurances and costs between $200 and $300 to get done. Another page covering medications okay for colds, flu and hay fever. I also received a booklet pamphlet about the expanded AFP for women under 35. Any opinions on this screening? They also gave me this really nifty spiral bound book covering pregnancy, childbirth, and infant care. It doesn't go into a lot of depth, but still really nifty! My favorite part is the list of recommended reading, which doesn't include "What to Expect" but does include other books that are awesome instead. Unlike my last pregnancy, this practice did not hand me any formula sponsored freebies! So, just from that above I'm really much more comfortable with this practice and it doesn't feel like settling for inferior care. I have to make up my mind on those tests above though by next appointment later this month. The nurse gave me the lab slip for the preliminary tests (blood and urine screening tests) and asked which doctor I would prefer. I mentioned how I know very little about any of them, but instinct said I should go with the one with small hands. She thought that was funny of course and recommended the female doctor in the practice. The nurse then mentioned that the next appointment would be the full exam with pelvic pap smear and ultrasound. =o/ I asked which kind of ultrasound it would be, in case I need to guzzle some water down. She said, "Oh, vaginal because it's the only one that would show the pregnancy this early." To which I reply, "Really? At seventeen weeks now, I would still need a vaginal ultrasound? I'm sorry but babies are allowed out of never never land, it's restricted access in the other direction!" =oP She didn't realize I was that far along, because she trusted my calculated due date and wasn't really thinking I suppose, lol. So the nurse suggested that would be good discussion for the appointment with the doctor. Then we went on our merry way across the building to the lab. Juliet was horrified and yet fascinated by the blood draw. Thus ended my first appointment at 17 weeks 2 days along in this pregnancy. My next appointment is on Tuesday March 22, when I will be 19 weeks and 2 days along. Laurel -- Birthmom to Bj 4-12-96 mommy to Juliet 4-13-02 and someone new due 8-14-05 |
#3
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That's good, I'm glad your appointment went well and you have sorted out insurance issues. I've never heard of a practice having an official policy on children, obviously for some appointments it's not appropriate and others you need another grown up there, but for standard checks with my midwife I would take DS, similarly regular docs appointments, where I wouldn't usually take DH along. Anne |
#4
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Hi Laurel,
It sounds like a pretty good environment. I'm glad! I also received a booklet pamphlet about the expanded AFP for women under 35. Any opinions on this screening? Do you have a specific name for that test? I wonder about dates, too. I'm doing the "integrated screen" this time around, which is an expanded version of the quad screen, which is an expanded version of the triple screen, which includes AFP. I'm not over 35, and they haven't mentioned anything age related about this (maybe because it's pretty non-invasive?). Basically, it involves an u/s around 12 weeks to measure the nuchal fold and crown rump length, a blood draw the same day, and then another blood draw between 15 and 18 weeks. If this is the test you're talking about, you are probably too far along to do it. Even for the AFP test, if you want it, I think you should call back and double check dates. 19 weeks might be too late. (My understanding is that these tests each have a specific window of pg that they are valid for, and beyond that there's too much variation or whatever their measuring gets drowned out by other factors. But that's just a layperson's guess.) Emily -- DS 5/02 EDD Labor Day 9/5/05 |
#5
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Emily wrote:
Do you have a specific name for that test? That was the specific name given. It's a California screening program if that helps. It's just the blood draw with the possible follow-up testing depending on the results. If this is the test you're talking about, you are probably too far along to do it. Even for the AFP test, if you want it, I think you should call back and double check dates. 19 weeks might be too late. (My understanding is that these tests each have a specific window of pg that they are valid for, and beyond that there's too much variation or whatever their measuring gets drowned out by other factors. But that's just a layperson's guess.) Yeah, the booklet gives the following text: "The blood test can only be done reliably between 15 and 20 weeks of pregnancy. The best time is 16 to 17 weeks." So I wouldn't be in the ideal weeks, but still within their suggested window of testing time. The website given on the back of the booklet is http://www.dhs.ca.gov/gdb Laurel -- Birthmom to Bj 4-12-96 mommy to Juliet 4-13-02 and someone new due 8-14-05 |
#6
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SuperEeyore wrote:
Emily wrote: Do you have a specific name for that test? That was the specific name given. It's a California screening program if that helps. It's just the blood draw with the possible follow-up testing depending on the results. If this is the test you're talking about, you are probably too far along to do it. Even for the AFP test, if you want it, I think you should call back and double check dates. 19 weeks might be too late. (My understanding is that these tests each have a specific window of pg that they are valid for, and beyond that there's too much variation or whatever their measuring gets drowned out by other factors. But that's just a layperson's guess.) Yeah, the booklet gives the following text: "The blood test can only be done reliably between 15 and 20 weeks of pregnancy. The best time is 16 to 17 weeks." So I wouldn't be in the ideal weeks, but still within their suggested window of testing time. The website given on the back of the booklet is http://www.dhs.ca.gov/gdb On that site, I found this page, which is what I think you're talking about: http://www.dhs.ca.gov/pcfh/gdb/html/PS/PS.htm This looks like what I've heard called the "triple screen" elsewhere. From what I know, the important thing to know going into this test is that it is just a screening test, and not a definitive test for any of the disorders listed: Trisomy 18, Downs, NTDs, abdominal wall defects. Certain NTDs are incompatible with life, others are quite minor. One kind of reading (high, I think) on the AFP would indicate a possible NTD. The follow up would be an ultrasound. Low AFP indicates possible Downs, again the follow up would be an ultrasound to look for various markers (still not definitive) and then possibly amniocentesis. Similar stories go for the other two. They don't mention it on that page, but a high AFP reading can also be caused by placental problems. That's what caused mine last time around. In the weekend in between hearing that result and waiting for the ultrasound, we held onto the possibility (something like 60%) that the high AFP was caused by placental problems as a good thing (at least the baby's fine). Unfortunately, the placental problem (and they still don't really know what it was/what caused it) that I had meant that I couldn't carry the pregnancy to term. I'm taking that test again next Monday, and boy am I looking forward to a normal result! So as to whether or not you want the test, I think it's a question of what you would do with the information, how much you mind having a blood draw (that's all it is), and how you would feel about making decisions about the next step (if it comes to that): the further testing (ultrasound, amnio -- you can obviously say yes to one and no to the other!). I hope some of that helps. Emily -- DS 5/02 Scheherazade, stillborn at 20 weeks, 3/2/04 EDD Labor Day 9/5/05 |
#7
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Anne Rogers wrote:
I've never heard of a practice having an official policy on children, Yep, my last ob-gyn practice had a policy of no children over the age of six weeks for the health of the patients. I was really worried this practice would be just as anal. Laurel -- Birthmom to Bj 4-12-96 mommy to Juliet 4-13-02 and someone new due 8-14-05 |
#8
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I've never heard that before-how ridiculous and inconvenient for women
pregnant with their 2nd or more baby! Kelly #4 2/15/05 "SuperEeyore" wrote in message ... Anne Rogers wrote: I've never heard of a practice having an official policy on children, Yep, my last ob-gyn practice had a policy of no children over the age of six weeks for the health of the patients. I was really worried this practice would be just as anal. Laurel -- Birthmom to Bj 4-12-96 mommy to Juliet 4-13-02 and someone new due 8-14-05 |
#9
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Yep, my last ob-gyn practice had a policy of no children over the age of
six weeks for the health of the patients. I was really worried this practice would be just as anal. you mean not even in the waiting room? yikes, that does make life difficult, I've often left DS in the waiting room with either DH or a friend. Anne |
#10
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SuperEeyore wrote:
I also received a booklet pamphlet about the expanded AFP for women under 35. Any opinions on this screening? What, precisely, is this? Nuchal translucency? Basically, in my opionion, all these screening tests are quite similar in that they don't give you a definite answer, but they do give you an idea if you're in a pool of women with increased risks. Just mathematically speaking, the more tests you do, the more accuracy (up to a point). I think the main thing is to understand what you're going to do with the information. The screening tests are not invasive, so you're not running much of a risk to take them. However, what would you do with a positive screen? Would you go on to amnio? Would you do anything different if you had a positive amnio? If a test doesn't cause you to do anything different, it's of less value than a test that would cause you to do something different. Best wishes, Ericka |
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