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

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

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

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

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

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

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

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

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

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