Aug 11, 2012

My First OB Appointment and Question List

On Wednesday I had my first appointment with OB/GYN at Adriatica Women's Health.  Casey and I made the decision to stick with an OB that we know and trust, even though the office is in McKinney (about 35 miles from our house) which means the delivery hospital will also be in McKinney.  We struggled a bit with this decision because it means if I end up on hospitalized bed rest, I will do that in McKinney (probably at the brand new Baylor McKinney facility).  This will make it hard for Casey to come see me every day (silly rush hour traffic to the suburbs), but after talking to other folks who did hospitalized bed rest, it seems the still working husband frequently can't visit every day even if the hospital is close.  At least if I am in McKinney my mom and sister are both nearby to visit during the day. We really trust Dr. Halderman and know she will take great care of me, Pip, and Pop.  In the end, that trust won out over any possible inconvenience.

I ended up going to this appointment alone, my first post-pregnancy appointment without Casey.  He was with his family at the graveside service for our sister-in-law's father who passed away last week.  We were both exactly where we needed to be, but it was hard being apart.  I both wanted to be with Casey and our family offering my support and condolences and wanted Casey to be with me at the appointment asking his questions and acting as another set of ears to help understand what we learned.

The appointment was completely painless and I left feeling really comforted by where we are in this pregnancy.

First, I went back for an ultrasound and got to wave hi to Pip and Pop!  They both looked great and we got heart rate measurements for the first time.  Both babies sounded great with rates of 167 and 185 (185 goes to the wriggly baby from these videos). I was told anything over 120 is healthy so we are really happy with those numbers!

Next, I met with a midwife who gave me information about services, diet, questionable foods, delivery hospitals, classes offered, and explained global billing.  Global billing means we will be billed for everything pregnancy related all at once when the babies are born.  She also gave me TONS of things to read and look over during the next few weeks.

Finally, I met with Dr. Halderman who performed a basic exam and then asked and answered lots of questions.  I had A LOT of questions written down! 

Some highlights of the Q&A (I won't bore you with every answer - this was an hour long discussion people!)

  • The OHSS is still a concern, but only due to the size of the cysts.  We will check my ovaries again at my next appointment in four weeks and see how it is progressing and talk more then.
  • The SCH is also still a concern, but again not a huge concern.  Typically for a hematoma, Dr. Halderman doesn't do full bed rest and didn't seem anywhere near as concerned about this as the RE did.
  • I am at higher risk of gestational diabetes because I am carrying twins, but research shows no increased risk from PCOS and insulin resistance.  There is nothing special I should be doing at this point.  I just need to eat healthy and gain weight to help Pip and Pop grow.
Bed Rest
  • In hugely exciting news, my bed rest has been modified even further.  In fact, it really isn't even bed rest anymore!  I am allowed "one activity" each day to get out of the house and get things taken care of.  I can go to church, to bible study, to dinner, on an errand, on a quick shopping trip, etc. as long as I only do one thing each day.  I also need to be smart about what I do.  No leisurely stroll around the entire mall, but I can hit up one or two maternity stores to find some clothes that fit. 
  • In light of this, I now have a handicap tag to make parking during my one activity less of an issue.
  • On Friday, I used my one activity to head to Target and look at buying a super cheap new bra that fits.  I was there for about 45 minutes and got what I needed.  Victory! Sadly, that night I had red spotting again.  Very disconcerting.  I know that the amount was so small that it isn't a big concern, but I hate that I have to think about it at all.  This SCH has got to go! 
General Health
  • At 14 weeks, I can start drinking decaf tea!  This is really exciting.  Chamomile and peppermint tea are both delicious, but a cup of black tea is really my favorite.  Silly caffeine restriction from OHSS.
  • West Nile virus is an issue (although certainly not a huge one) and I will do a full post on this at some point next week.
  • My ear pain and the fluid in my ear is deserving of a trip to an ENT. The fluid is probably just from the additional fluids being produced by my body to support the pregnancy, but the concern is that it isn't draining well and so led to an infection.
  • Dr. Halderman agreed with the medication step down schedule from the RE so no complications or issues there.
  • I am free to travel at 15-16 weeks for my cousin's wedding.  Yay!  I'll do a full post on the conversation Casey and I had about this sometime next week. (I'm promising a lot of posts - hope I remember to deliver!)
  • In terms of prenatal classes and multiple classes, Dr. Halderman recommended taking these between 20 and 30 weeks. That is hugely comforting! One of my books on twin pregnancy said to have all classes completed by 20 weeks to ensure you finished them before any need of bed rest.  The idea of trying to fit that in by 20 weeks was really overwhelming so doing it between 20 and 30 is much more comforting!  The only question is whether Baylor McKinney offers a multiples class.  It is not currently listed on their offered classes, but perhaps they will have one by November when we need it. If not, that class will have to be taken at Baylor Dallas.  Dr. Halderman is going to check on this for us.
Delivery  -- I saved this category for last because, at least in my opinion, the answers here were the most exciting!
  • Dr. Halderman doesn't allow twin pregnancies to progress past 37 weeks due to increased risks (some quick googling revealed that twin pregnancies in later weeks can have higher risks of complications and still birth due to the placenta breaking down).  This means that while our due date is technically February 28, our last possible delivery date is February 7!  It is crazy to see that in print.  At the latest, we will meet Pip and Pop the first week of February!
  • While we are hoping for 2013 babies, a good estimate for birth is between 30 and 37 weeks.  This puts our range between December 20 and February 7.  Obviously, the longer they cook the better, so we are not hoping for Christmas babies (like my Dad was!) or New Year's Eve babies (like me!).  2013 sounds like a great year to be born!
  • In terms of delivery method, Dr. Halderman only recommends vaginal delivery if both babies are head down, which is extremely rare.  If only one baby is head down, you risk having dual delivery methods if the second exit-er requires an emergency C-section.  If it turns out both are head down, we can reconsider my hippie desire to have an intervention free birth, but since I'm not at all interested in a full-birth experience, I'm thinking a C-section sounds like a good plan! 
Overall, the appointment was a really positive experience!  I am feeling more and more hopeful that this pregnancy will actually result in babies! I don't go back for another four weeks.  On the one hand, this is really comforting.  It means the babies aren't in danger and so she doesn't need to see me.  On the other hand, I haven't gone more than a week without an ultrasound this entire pregnancy.  How am I supposed to go four weeks without knowing for sure the babies are okay?!? 

I am bit nervous because they were unable to schedule my next appointment while I was there.  Dr. Halderman's schedule was full so they are going to have a scheduler get back to me and see what can be put on the calendar.   I have no doubt it will get worked out, but it is just one more thing to worry about!

1 comment:

  1. Congratulations on your two bundles of joy! And also, your OB-GYN appointment sounds like a success. But, I do feel your hesitation going alone on these visits. It would be best if you have someone to assist you during these check-ups. But if there is no other option, just make sure that you set your appointment on time, so there will be less hassle and stress. Don’t worry. I’m sure your hubby will accompany you next time. And in regards to the risk on gestational diabetes, you just have to watch what you eat, and stay on your preggy diet! And don’t forget to follow your doctor’s advice.