OB advice?

OB advice?

sch1star
sch1star

April 2nd, 2011, 12:44 pm #1

If all is well, no more RE in a little more than a week. From your experiences, are there particular things you looked for in selecting an OB? It looks like no multiples, so I'm not too concerned about access to an over lvl 2 nursery....I'm trying to think of the OB equivalent to those things like "avoid a practice that wants you to do the CCT."

Do all offices refer to a perinatologist for NT scan? Are there statistics I should ask for or certain attitudes/policies to fish out?

I seem to too often end up saying "I wish I had thought of..." and just trying to avoid that. Tyvm
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Mrs. A
Mrs. A

April 2nd, 2011, 2:09 pm #2

how experienced they are with dealing with infertility patients. For me, that's my biggest gripe with my current OB. I chose him years ago, (when I thought getting PG was going to be easy), based on hospital privileges, the fact that he's a solo practice, and my GYN at the time also supported me selecting him. Fast forward years later and I'm PG after this crazy battle and naturally a nervous nelly and I find that my OB (despite me being very frank with him on my needs) doesn't get it. What I once saw as a positive - calm, laidback demeanor - I now see as frustrating. I've also seen a different side of him as an OB vs. as my GYN. Luckily - my RE (Dr. Check/Cooper) kept me under care until 11 weeks so I was getting all the warm and fuzzy treatment from them.

Is there a reason why you wouldn't use your exisiting GYN? Does he/she not OB?

Are you in Boston proper or outskirts? I have an IVF friend who is also a GYN (she's not OBing) and she's up there. I could ask her for a reco.

As for the NT, I'd responded on a prior post re: my experience - not sure if you saw.

http://www.network54.com/Forum/264844/m ... C+no%2C+no
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sch1star
sch1star

April 2nd, 2011, 4:51 pm #3

I didn't see that the other day, I'm sorry! It's very helpful.

I only found my OB because I needed someone local to help me with my Cornell workup and f/u. So well into my IF. We don't have a lengthy relationship. It's not a solo practice, and although I like her and the office okay, and I also like the hospital where she has privileges, some things have also happened over the course of this battle that have made me a little uncomfortable. For example, when I asked if she would do a polypectomy, she rolled her eyes and said she doesn't make her pts who are trying to get pg get rid of a little polyp. And then after she was in there she said the fibroids were nothing...later I had to have an extensive myomectomy. Granted the nasty little sucker grew under the influence of stims, but it just left me wondering.

We are west of Boston, about 45 mins. Because of my previous life in health care, I'm tough on community hospitals. In general they don't attract the staff or funding to provide the best care. There are certainly exceptions. But that's the worry I start with, so I don't rule out traveling to Boston or Worcester. I would welcome any recommendations, MDs always know the best MDs. The current OB has privileges at Emerson and they actually look pretty good for L&D.

Gosh, warm and fuzzy would be a really nice break after IVF factory style. Everybody, line up and drop your panties!

The genetic counselor is a great suggestion. It's a career path I considered following (to the point that I applied to programs), so I have just enough background to probably be a terrible PITA. Lol! I curse the graduate work in biostatistics now.
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Joined: August 28th, 2007, 1:04 pm

April 2nd, 2011, 5:26 pm #4

Like, you, I'm about 45 minutes outside the city (north). I have to tell you that based on my experience and those of others I met on these boards, OBs outside the city don't really take IF into consideration when dealing with you as a PG patient. OK, that's a pretty broad statement and I'm sure there are exceptions, but when I was PG with DS#2 in 09, there were a few others from this area on the board and they had the same experience I did.

I did stay with my local OB because I like her a lot. She's very thorough when it comes to being a gyn and she's an awesome surgeon who was masterful with my c-section! (Barely a scar!) But when it came to me needing reassurances, I went elsewhere. I stayed with my RE until 11 weeks, and had all sorts of scans. My OB was really surprised when she heard I wanted to do an NT scan. Her office offered them (technicians do the scan, OBs read the results), but I couldn't get an appt., and as you know, there's a small window when you can have them done. I ended up booking mine with Beth Isreal Deaconess. A technician did the actual scan, but a peri (who I never saw) read the results and sent them to my OB.

As part of the NT, you meet with a genetic counselor who goes over risk factors, family history, etc. Then they do part one of the b/w. You'll then go for the scan. The b/w takes a bit to come back (although some places I've heard of do the b/w a few days in advance of the scan so that it'll be there when you have the scan, but BID didn't do that). The genetic counselor called me with the results a week or so after the scan.

As far as the 20-week u/s, a Boston peri from Tufts who was affiliated with my OB's office did mine in a local setting.

A friend of mine, Lindy, who's on these boards (just had #3 last month) goes to a Boston OB I believe. If she checks in, she could probably give you more info on Boston OBs. A major consideration that made me hesitate about having the baby in the city was the commute. I could totally picture my DH delivering the baby in the backseat in 93 traffic!!!!

Anyway, GL, whatever you decide to do!

Hugs,
Meg
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Joined: September 19th, 2010, 9:20 pm

April 2nd, 2011, 5:34 pm #5

I didn't see that the other day, I'm sorry! It's very helpful.

I only found my OB because I needed someone local to help me with my Cornell workup and f/u. So well into my IF. We don't have a lengthy relationship. It's not a solo practice, and although I like her and the office okay, and I also like the hospital where she has privileges, some things have also happened over the course of this battle that have made me a little uncomfortable. For example, when I asked if she would do a polypectomy, she rolled her eyes and said she doesn't make her pts who are trying to get pg get rid of a little polyp. And then after she was in there she said the fibroids were nothing...later I had to have an extensive myomectomy. Granted the nasty little sucker grew under the influence of stims, but it just left me wondering.

We are west of Boston, about 45 mins. Because of my previous life in health care, I'm tough on community hospitals. In general they don't attract the staff or funding to provide the best care. There are certainly exceptions. But that's the worry I start with, so I don't rule out traveling to Boston or Worcester. I would welcome any recommendations, MDs always know the best MDs. The current OB has privileges at Emerson and they actually look pretty good for L&D.

Gosh, warm and fuzzy would be a really nice break after IVF factory style. Everybody, line up and drop your panties!

The genetic counselor is a great suggestion. It's a career path I considered following (to the point that I applied to programs), so I have just enough background to probably be a terrible PITA. Lol! I curse the graduate work in biostatistics now.
I see now why the hesitancy (word?) about using current OB. Going by your comments, I'd look for someone else too. Also, sooner rather than later you will want to get your records from Cornell, at the very least for this IVF cycle, in case your new OB requires it.

This was a sore point for my OB. On the day I went for my first prenatal visit he was flipping like a jacka$$ because he didn't have any records for me. "How can I give you proper care when I don't have any records on you?!" BLAH BLAH BLAH. I explained to him that it was a natural PG so there was NOTHING to tell as far as my cycle other than because I had been monitored I knew the exact date of my ovulation. Still wasn't enough for him although he eventually settled down.

I don't know that solo practice is better or not, but since I have ONLY been with a solo practice GYN ever since I started going as a teenager, it's just my preference.

I know what you mean about the factory style. Never mind the jam packed wait area; I remember walking into that conference room with all the other ladies in the wee early morning hours day before ER...ugh.

BUT - no matter - that's in the past!! On to happier times!

Btw, what is a community hospital? By me they are all "medical centers".
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Joined: September 19th, 2010, 9:20 pm

April 2nd, 2011, 5:47 pm #6

Like, you, I'm about 45 minutes outside the city (north). I have to tell you that based on my experience and those of others I met on these boards, OBs outside the city don't really take IF into consideration when dealing with you as a PG patient. OK, that's a pretty broad statement and I'm sure there are exceptions, but when I was PG with DS#2 in 09, there were a few others from this area on the board and they had the same experience I did.

I did stay with my local OB because I like her a lot. She's very thorough when it comes to being a gyn and she's an awesome surgeon who was masterful with my c-section! (Barely a scar!) But when it came to me needing reassurances, I went elsewhere. I stayed with my RE until 11 weeks, and had all sorts of scans. My OB was really surprised when she heard I wanted to do an NT scan. Her office offered them (technicians do the scan, OBs read the results), but I couldn't get an appt., and as you know, there's a small window when you can have them done. I ended up booking mine with Beth Isreal Deaconess. A technician did the actual scan, but a peri (who I never saw) read the results and sent them to my OB.

As part of the NT, you meet with a genetic counselor who goes over risk factors, family history, etc. Then they do part one of the b/w. You'll then go for the scan. The b/w takes a bit to come back (although some places I've heard of do the b/w a few days in advance of the scan so that it'll be there when you have the scan, but BID didn't do that). The genetic counselor called me with the results a week or so after the scan.

As far as the 20-week u/s, a Boston peri from Tufts who was affiliated with my OB's office did mine in a local setting.

A friend of mine, Lindy, who's on these boards (just had #3 last month) goes to a Boston OB I believe. If she checks in, she could probably give you more info on Boston OBs. A major consideration that made me hesitate about having the baby in the city was the commute. I could totally picture my DH delivering the baby in the backseat in 93 traffic!!!!

Anyway, GL, whatever you decide to do!

Hugs,
Meg
getting my b/w done ahead of the NT scan but that's a big NO NO at my hospital. They require it to be done at the same time so that the b/w results and the NT scan are in sync as far as gestational age.

Also, because I had sooooo many Qs at the time that I was booking my NT scan and Part 1 of Sequential, they recommended I have a separate meeting with the counselor first, weeks in advance of my NT scan. Then once the NT scan was done, and b/w in, I met with my OB for the results and later had yet another phone consult with the genetic counselor to go over the results (again).

I was actually glad I met with the counselor first because she recommended changing my NT scan date for a few days later. The date I had selected with the front desk put me at exactly 11 weeks but the counselor said that sometimes when your're that close to the window it can be hard to have definitive measurements and so you have to go back. She said to avoid that experience to push out the date by a couple of days. Instead I chose to be totally safe and scheduled it for 12 weeks.
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Alli
Alli

April 2nd, 2011, 6:08 pm #7

If all is well, no more RE in a little more than a week. From your experiences, are there particular things you looked for in selecting an OB? It looks like no multiples, so I'm not too concerned about access to an over lvl 2 nursery....I'm trying to think of the OB equivalent to those things like "avoid a practice that wants you to do the CCT."

Do all offices refer to a perinatologist for NT scan? Are there statistics I should ask for or certain attitudes/policies to fish out?

I seem to too often end up saying "I wish I had thought of..." and just trying to avoid that. Tyvm
I'd go to the best place you can. There were lots of small little singletons in the NICU I was at in MUCH worse shape. Dont take any chances- Level III NICU and high risk OB. You get more US and personal attention. IF demands this I think and gives you absolute best care.
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Mrs. A
Mrs. A

April 2nd, 2011, 6:24 pm #8

you never know what can happen. God willing nothing will though!!
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ZakiaZ
ZakiaZ

April 2nd, 2011, 6:38 pm #9

If all is well, no more RE in a little more than a week. From your experiences, are there particular things you looked for in selecting an OB? It looks like no multiples, so I'm not too concerned about access to an over lvl 2 nursery....I'm trying to think of the OB equivalent to those things like "avoid a practice that wants you to do the CCT."

Do all offices refer to a perinatologist for NT scan? Are there statistics I should ask for or certain attitudes/policies to fish out?

I seem to too often end up saying "I wish I had thought of..." and just trying to avoid that. Tyvm
an obgyn who would be sensitive to my journey through IF and that they would have an understanding of my fears, anxieties, needs, etc. and I found her. She is AMAZING. The first thing she said to me when I walked into her office is "My job is to worry for you. If I'm not worrying, then you don't need to."

She was my rock through both my pregnancies. She let me come in every two weeks vs every month for my regular visits and at the start of the 3rd tri, I went in weekly. She understood my fears and always told me when she'd be at the hospital so that if I was freaking out for any reason, I could come in and she'd do an u/s. If she wasn't there, she would tell me who was on call. She went through a LOT to accommodate me. She answered all my "stupid" questions and even when I had the + for downs syndrome, she was very honest to me about "what she would if she was in my shoes" - nobody else would give me a straight answer.

Luckily I delivered healthy normal babies both times and as difficult as my pgs were emotionally, they were MUCH easier with my care in her hands. I took a lot of time and did a lot of research to find her. I wanted the best and didn't settle.

Everything fell into place once she took me as a patient. Of course she must be good and experienced at her job but the other stuff was equally as important. As long as your obgyn of choice is in good medical standing then the most important thing to me, is their bedside manner. My obgyn's mantra was "Zakia gets whatever Zakia wants." That attitude told me a LOT about how I would be treated and I have no regrets. She was a blast during my 2 c-secs. which SHE led. I can't believe she was eating lunch on the run just mins. before she got into my guts - ick. But it was nothing for her. Plus I'd rather she eat than pass out from low blood sugar mid surgery

Her staff was also amazing and I never had to wait more than 10 mins. or so, even in the worst snowstorm, she would WALK to her office to see her patients if she couldn't drive.

GL I hope you find the best obgyn possible.
Z.

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Shipin
Shipin

April 2nd, 2011, 10:32 pm #10

If all is well, no more RE in a little more than a week. From your experiences, are there particular things you looked for in selecting an OB? It looks like no multiples, so I'm not too concerned about access to an over lvl 2 nursery....I'm trying to think of the OB equivalent to those things like "avoid a practice that wants you to do the CCT."

Do all offices refer to a perinatologist for NT scan? Are there statistics I should ask for or certain attitudes/policies to fish out?

I seem to too often end up saying "I wish I had thought of..." and just trying to avoid that. Tyvm
Sensitivity to IF is defenitely imp for couple of reasons. This pg is VERY imp for u.... An lax attitude will frustrate u , secondly if u r in p4 weening phase then ob shoul be ready to comply with your RE schedule. I always prefer someone from a group practice rather than individual. My ob had Fertility specialists in the practice and she was open to referring me to him if I was concerned about anything. Check his/her hospital affiliations for delivery. Ask about natural to c-sec ratio. Some practices favor c-sec .if u want c-sec then fine else u need to b careful. In case of natural find how many weeks post term they let u go. 1 week is standard but they all have different protocols.
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