OB Trumps Peri

[reynolv]

I had a really good appointment with my ob/gyn today. I actually met with a nurse practitioner, but she was wonderful and addressed all my concerns. I felt she took me seriously and was very proactive and willing to treat me if I do develop pre-e. What a difference! When I asked about the doctor's philosophy about treating me, if I do develop high bp's (160/100), with antihypertensives, she sounded like it was the norm to treat when levels are that high, as opposed to the "peri" I saw that said he usually only treats if there is chronic hypertension. She agreed that I would need to be watched more closely if I am placed on antihypertensives, but at least she was willing to do so if needed, unlike the peri who stated that the only treatment for pre-e was delivery (ready or not) and that antihypertensives just "mask" pre-e symptoms. From uncompassionate, unconcerned, and uninformed (the peri) to a "mere" nurse practitioner that was all the opposite.

She also prescribed some Tylenol 3 for my recurrent headaches, prescribed urine strips to check for protein, talked about a home monitoring program with daily monitoring if things get worse, and she congratulated me for being proactive and watchful. She even ordered an ultrasound to check for dating because I'm a bit large for date (twins? - shudder -). I felt like she addressed all my issues and concerns and felt so relieved after my appointment and thanked her profusely. I feel a lot better about my ob care at this point and will leave it at that, though I still have the info about the peri in Scottsdale if it came to needing more specialized care, but needless to say I am very relieved. I was just getting ready to search for another peri that would be more amenable to treatment and who didn't sound like he was quoting a textbook or was just out of med school.

Anyway, I want to thank you all for your support and great ideas and comments. I feel like I am on my way to good obstetric care, finally. Thank you all for encouraging me to seek it! I feel a renewed sense of hope that maybe I can make it through this, whether pe strikes again or not. Just wanted to let you all know how well things worked out. I'll keep in touch and let you all know how things are going, but so far so good. Thank you all again! [:)]

Veornica
Jared - 12/26/00
induced 35 1/2 weeks
due to pe

[laura]

I'm so glad to hear this! be sure to send that provider's name to your state chaper coordinator, so they can recommend this person to others that may be having similar problems!

let us know how you're doing![:D]

Laura-28
DH Jack-30
Allie 5-13-98 (35 weeks-pre-e)
Baby Camille 4-17-03 (36 weeks- htn and oligo)
http://www.babiesonline.com/babies/c/camilleandallie/

[erin2003]

Veroncia,

That is wonderful! Your OB sounds wonderful! I am so happy you found someone that will be proactive and you can "trust"!

I can't wait to hear how you make out at your u/s!

Erin [:D]

Me 27 DH 28
^|^ Jackson Andrew
Jan 21-25, 2003 (27w5d)
Pre-E, HELLP
EDD #2 Jan 6, 2004
C-section scheduled for Decemeber 31, 2003

[mada]

I am so glad you finally had someone who really "listened" to you!! I see a nurse practioner for my regular doc and I love her!!! She seems so much more knowledgable then half the docs I've seen[:)] Hang in there and let usknow if you have a couple buns in the oven!!

Mada Harpster

Sam 6-29-00 36weeks P.E.
Ben 11-03-01 No P.E.

[deerhart]

Actaully, it is very much thought in some circles that Blood pressure medication does not stop PE but does rather mask the condition by forcing the BP lower but the other symptomns internally continue.

My ob does not treat with medication for this reason as she is afraid that if the BP is lower, then woman may write off other symptons as just being pregnant and not report them because their BP is fine. In addition, she has fairly strict guidelines at what she will allow a BP to stay at and how long. In comparision, at 160/100 would basically be hospitilization time to monitor the BP for at least a 24 hour period, and a reading over 140/110 its time to deliver. Unlike other doctors who will continue on.

If you think that PE is not caused by the high BP, instead the high BP is a symptomn of PE, then you are basically masking a symptomn with BP medications instead of treating the condition. If a woman has chronic hypertension, then you are treating the condition and not the symptomn. Its like twisting your ankle and taking medication for the pain. It masks the pain, but doesn't mean the reason for the pain is gone.

To me, it looks like the OB takes the point of view that the BP causes the problems and if you control the BP then you control the problem. On the other hand, the Peri is taking the point of view that the BP is a symptomn and by using BP meds you cover up an easy symptomn that tells you how bad things truely are.

Just antoher way to look at it rather then thinking that the Peri is being uncompassionate, unconcerned, and uninformed.

This point of view is one that is taught at one of the top medical schools in the country (my ob/gyn teaches at the big medical school here).

Erin

Mommy to Alex and Mason

[reynolv]

I am really glad to have found my ob and I get my ultrasound on Halloween. Not a great day, but I'll take it. I am a bit concerned as to why I am large for date. I don't relish having twins and going through twice the risk, or at least increased risk of going through this all over again.

I did actually do some research on bp meds, and though I know it is still very controvercial, I feel it would have helped me a great deal. I know it does not get rid of pe, but I think it can help things go a bit longer, as long as your are watchful. My bp's did hit 160/105 in the ob's office and 180/110 at home, but all my ob told me to do was lie down on my left side. I didn't even know there was another option. I've checked around on the "Ask the Experts" area of this site and asked some questions, and I feel pretty good about going the route of the bp lowering meds if pe does strike again. If it does mask the symptoms of high bp and maybe protein in urine, then I'm with the experts on this forum and feel those are pretty good things to mask.

I did discuss the need for more careful monitoring with my ob, taking into consideration that bp's would indicate lower than they were showing up. She also talked about a home monitoring program that would have daily check in with nurses and my at home monitoring. Honestly, I'd just like to look at any route that would help me avoid the same or worse results than my last pregnancy.

It wasn't just the peri's view about not treating high bp's with antihypertensives unless there was chronic hypertension that made him, what I thought, was uncompassionate, but it was his entire lack of trying to help me deal with any of my concerns other than my gestational diabetes, which I have under fair control and am watching carefully. He wasn't helpful with my headaches, he didn't seem concerned about my previuos pe and his attitude seemed to be that previous pe was not something to be overly concerned about. Whenever I tried to steer the discussion back to pe, he just pretty much skirted my efforts. I left with a feeling that it was practically a waste of time. I'm sure there are many wonderful peri's out there. I have read about some of them in this forum, but mine was not one of them. I just felt all around, like he didn't care, and was too busy taking care of "really" sick women to bother with my concerns. He actually said the kind of women he sees in his practice are so sick that it would make me "not want to be pregnant," indicating that pe and gd were not that big a deal.

I'm pretty happy with my current ob/nurse practitioner and care, but I'm certainly not lulled in any way. I will be very watchful. But for the first time since I started having those familiar symptoms, headaches, swelling, weight gain, feeling horid, I am feeling a sense of hope that maybe I can have this baby safe and sound, and this is my goal. I will continue to keep close to this wonderful resource to get me through the long weeks ahead to a hopefully happy result.

Veornica
Jared - 12/26/00
induced 35 1/2 weeks
due to pe

[reynolv]

Just an update, had my ultrasound on Halloween and all seems normal. Baby's size is right on track at 12 weeks 6 days (I was 12/5 that day). They also said that there is only one baby, not twins (whew!), and that all looks good so far. I know I've got a long way to go, but it was reassuring to know that so far, so good. Now five more weeks for my level 2 ultrasound.

Still keeping track of my blood sugars and bps and so far, nothing too alarming, but blood sugars are starting to go up a bit, probably a bit too much Halloweening, though I've tried to be really careful. I guess even those teeny weeny sized ones can get ya! [:p] I'll be really happy to be my main ultrasound at 18 weeks and see that all is well and then hit the mid point. Forty weeks is a long time, but so far so good. Thanks for all the support and great info! I'll be in touch with any new developments and I'll stay close to the site in the meantime.
[:)]

Veornica
Jared - 12/26/00
induced 35 1/2 weeks
due to pe