Monday, May 07, 2007

Can't Sleep

I had a tremendous migraine all day and it only got worse toward the end of the day. Having a dentist appointment probably didn't help matters. Now I'm in slightly less pain, but can't sleep, as is often the case after a long migraine day. I think that the migraines are actually getting worse, which is almost hard to believe. Suzanne also reminded me that I never updated you all on the other lovely pain in my life... the kidney stone. Well, it seems to be gone. I think I passed it last Sunday and on Tuesday I had a renal ultrasound and all was clear, which is good. Frankly, I'd rather have a couple more kidney stones than these ever-pervasive migraines at this point. Bleh.

Anywho, enough complaining. Last Thursday, of course, was the nuchal scan that I've already updated about. On Friday I saw my regular OB. These appointments are rather useless as I basically go in, he asks how I'm feeling, I say I feel like hell, he listens for one of the heartbeats (hard to differentiate on doppler), and that's about it. I broached the subject that perhaps it made sense to transfer my care for this pregnancy directly to the perinatologist.

Now, I should pause here remind you that this was NOT my initial desire. I love my OB and originally any mention anyone made of leaving him for this pregnancy was met with my icy glare. However, the truth is, it really makes sense to me at this point. The best equipped doctors to handle the ins and outs of a triplet pregnancy are the perinatologists I'm seeing. Having two sets of doctors directing my care, particularly with the perinatologists being the experts but going through the OB to direct critical care decisions, does not seem advantageous to me. The perinatologists (all three in the practice) have all been very, very willing to do whatever I'm comfortable with. They've been effusive in their praise of my OB specifically and of the practice as a whole. I'm not concerned about my care, but I do not honestly see any true advantage to having two sets of doctors at this point.

Right. But being that I love my OB and certainly don't want to alienate him or lose him as my doctor for postpartum care, future pregnancies (hah!), and well-women's care, I broached the topic very gently. This is in part because I'm sensitive to the fact that I love him, and partly because I completely lack the ability to have any sort of confrontation with a doctor. I'm a wimp, essentially. So I mentioned that Dr P (the evil one, not the wonderful one) had suggested transferring my care, and my OB brushed it off. He didn't see any need to transfer my care. Oh no, he said, they can totally handle it (and no doubt they can, but still... is there any real ADVANTAGE to having two sets of doctors? Not that I can find!). Since my next appointment with the perinatologist is in two weeks, he suggested coming back to his office two weeks after that, so that we wouldn't be seeing two doctors in the same week. Except that after this next two-week appointment with the perinatologist, I'll be seeing the perinatologist EVERY week, so the logic doesn't hold. But my OB said, no, I don't need to see them that often. And if they wanted to do cervical measurements every week, well, the OB's office could handle some of that.

But... but... I don't WANT two different offices trying to coordinate and compare cervical measurements!! It seems like there are too many ways that can be screwed up. And if the perinatologist tells me to be there every week, I'm going to be there every week, no matter what. I am NOT messing around with this pregnancy! But I'm a wimp, as previously stated. And the OB just seemed so sure of how this should go, and I didn't want any sort of confrontation, and I love him, so I just said okay and went to the front desk to make my next appointment for four weeks out.

Except I don't really want to do that. What I want to do is to transfer my care to the perinatologist. But without alienating my OB. I asked a friend who is a doctor (and has five kids of her own... mostly out of the house), and she said I should just transfer my care and tell the OB's office I'll be back for my post-partum care. She said there was no reason that should alienate the doctor or the practice, it's just the way it works. But it feels... underhanded. Sneaky. Deceitful, even. Still, I know I'll be a lot more comfortable with just one set of doctors to turn to if a problem occurs. Even though I completely 100% trust my OB and I know that he would defer to the perinatologists for any critical care decisions. It still seems convoluted to deal with both sets of doctors.

So... I don't know what to do. I mean, I know that the right thing to do is to transfer my care. I just don't know how to do it most appropriately and with the least possibility of alienating my OB. Bleh.

11 comments:

Casey's trio said...

Hi Karen,

Sorry to hear about your migraines. I get them periodically, but could not imagine having them constantly while pregnant with triplets. I hope you find some relief soon and get some rest. About the doctor issue, I agree with you 100% to go with the perinatologist and it sounds wonderful that you have met all 3 in the practice and like all of them! I loved my Peri (probably as much as you love your OB) and felt so much better knowing that he was an expert in high risk pregnancies. Hopefully, you can simply let your OB know that it is easier on YOU to only have to go to one set of dr appts.....the last thing you need is to bring more stress into your life by juggling the dr situation. The best part of the peri's office was ultrasounds at every visit, which won't happen with your OB!
Go with your instinct and put yourself first! Your OB should understand:)

Casey

decemberbaby said...

Ugh, I'm a wimp about that stuff too... but I'm the kind of wimp who would just cancel my next appointment and tell them I'd be back for postpartum care.

Sorry 'bout the migraines.

twirl said...

I agree with your doctor friend. If you tell them you'll be back, that ought to be enough.

I seriously doubt they'd ask any questions, but it's easy enough to say that coordinating two sets of appointments is too much for you to handle. (You're busy growing three humans, after all!)

In Search of Morning Sickness said...

First off, I'm soooo sorry about the migranes! Every story I hear about kidney stones talkes about immense pain, so if you're saying you'd prefer them to your migranes - OWWW! I really hope you can get some relief, I cannot understand how you can function with that level of pain!
Secondly, I totally get the whole doctor situation, but your instinct to keep it at the peri's office seems right. I am in the process of trying to transfer my IUI's to a place closer, and even though I have the dr's direct phone number at my current office, I don't want to talk to him directly because I don't want to hurt his feelings for trying to switch (even though I know he'd be supportive). Wimp.
You're right, we can bank J's sperm so I can use when he can't fly out. I haven't put a ton of research into it yet, but it's not cheap and in all honesty, right now J really wants to "be" there when/if his child is conceived. I want to respect that since it's only a couple of months.
Thanks for stopping by!

Carol said...

I think you have to do what feels right for you. The doctor's feelings aren't your problem. go with your gut - it will be right.

megan said...

i simply cannot imagine the pain of your migraines if you prefer a kidney stone to them. i hope you get some relief soon.
about the OB -- i'm a wuss about that kind of stuff too. your OB should totally understand though. you need to do what is best for you and the babies.

Watson said...

I am one of those pain-in-the-ass patients who feels as if I've hired my doctor and that I am paying (through my insurance, of course!) for his or her care.

I am their client, as well as a patient.

So when it's time to move on for any reason, I just do it. Sometimes I'm direct, as in telling them the reason why, other times I've just moved and had my records transferred.

You don't need ANY more stress!

If you feel more comfortable, I'd just take your friend's advice and tell them you'll be back for post-partum care and have any pertinent medical history sent over to the perinatologist.

If they make you uncomfortable at all, that's very unprofessional...so follow your gut, and make it as easy on yourself as possible.

(I'm actually WAY more nervous switching hair dressers for some odd reason. Doctors? No prob! But finding a new colorist? Good lord, the GUILT!)

Take care, 'k??

Suzanne said...

it sounds like you have made your mind up about your care...so do what YOU feel is right for YOU and your babies at any cost...and stick to it! sure doctors have egos, but they ultimately want what is best for you. always remember it is YOUR decision. take stress OUT of your life! ;)

Anonymous said...

Could you somehow have the peri do your dirty work for you? Could they request any info they needed?

Anonymous said...

Tell your OB what you explained here in your post. You explained it well.

If you are concerned something might go wrong and you'll want the assistance of your OB like you had last year but you won't be able to have it because you've transferred care, tell him that too. Proper arrangements to keep him in the loop should be able to be made.

Jody said...

I'm convinced that being seen by only one office, and that office being the MFM clinic, was the single greatest reason why I delivered my babies as late as I did. Transfer your care, call the nurse to explain that you simply will not have the energy or time to juggle appointments as the pregnany progresses, remind them that cervical length measurements are hard enough to compare without adding different offices and machinery into the mix, and sail off happily. Honestly, I saw my peri for my six-week post-partum exam (they insisted) and went back to my OB/Gyn office for the following year's pap smear.

I'm sorry about the migraines, but glad the kidney stone has resolved. I hope you can get your relaxation where ever it shows up.