OB-not GYN-man it's a whole new world

[Scarlett81]

I just realized my topic title-I didn't mean to sound like Jasmine and Aladdin there....DUR

SO I had my 1st appointment with my new Obstetrician yesterday in the good old big apple. I was so nervous that she was gonna be a crank, overly serious, or whatever. This was the doctor I had to use-period. This was her, no matter what. B/c she works with my Cf team in the same building, hospital. She does pregnancies with respiratory disease. There aren't many around in that field!

So I was so nervous I wasn't gonna like her. But holy moly she's so nice! Very intelligent. Very experienced. She will cooperate with me as far as my personal wishes for the labor and delivery. She wants to make this a relaxing, open, optimistic experience. She stressed that just becasue this is "high risk" pregnancy, we should not have a high risk outlook. We should procede as if all is completely normal. She also feels that as far as risk goes-for my case I am in the medium-low risk class. She feels I have good lung function to hold me up.

She feels that the most common high risk in my case is premature delivery. And, not to worry about the other most common complications in cf pregnancy.

So I now have a much more postivie outlook after getting all this info. This woman is on top of her game I believe. She's delivered lots of cf women, and countless other respiratory issued women.

All this stuff really is like learning another language. There's so much to learn. I really haven't wrapped myself around the events of the past few weeks. I think I am still in shock that I received this news. So, I'm gonna try to relax today and soak it all in. So I don't break down.

 

[NoExcuses]

Are there any risks being pregnant with cepacia?

 

[Jenica]

That's so exciting, Christian! I hope the whole pregnancy goes easily for you!

 

[EnergyGal]

That is great news!

 

[Scarlett81]

Amy:
As far as risks associated with cepacia-not for me at least. I say at least, b/c in some women apparently there are valid reasons why cepacia should hold them back. But the team says to view this on a very individual basis-all cf women's cases are different. No two are alike.

For me, there are enough drugs-non cepacia resistant- I could take if I got an exaerbation during my pregnancy, (that obviously wouldn't harm the baby). That's the main issue with cepacia pregnancies. Some women are immune to so many drugs already-then they get pregnant, get sick and have nothing left to use. So it shouldn't be a problem. Yea! I remember when I was so worried about that factor. But going to a specialist and getting educated it the only way to find out that stuff.

After seeing these doctors, I realize there is a lot of bogus info out there-well meant info, just wrong sometimes. They cleared up so much stuff for me, misconceptions I had. And also told me concerns that could come up that I hadn't even thought about.

 

[LouLou]

Christian, I'm so happy to hear you two clicked.

I'm impressed how fast they could get you in there. I have an appt. with a high risk OBGYN Aug. 9th. It seems you and I are on similar paths which you probably already knew from my previous posts. I went off birth control 3 months ago and am excited to report that I have had a relatively normal cycle thus far. I've been charting and seem to have similar behavior going on that is characteristic of a person recently off bc. The good news is that I seem to be ovulating, bad news is that I don't have a steady progesterone flow to maintain a pregnancy.

I'd love to hear more detail about your meeting with her...like concerns that might come up that you hadn't thought of and your mention of wishes for labor and delivery (are they CF related?)

Did she mention anything about conception and her preferred approach? What are your wishes? How long have you been off the pill?

So interesting and exciting!! Maybe we'll be pregnant at the same time. If I don't like my doctor here I very well might end up going to yours since I'm only an hour away.

One of my biggest concerns is cross contamination though so I won't likely be sauting someone out that works with a lot of respiratory troubled people. I'd be interested to understand why your CF doc. felt it necessary that you be with an OB that is respiratory specialized or is it rather a relationship that has proven effective and therefore a bit out of convenience?

 

[LouLou]

one more thing...
we've been charting to avoid pregnancy until I feel that my cycle is pregnancy conducive.

 

[Scarlett81]

Lauren-

WHOA! tons of questions, cool. Oh, and I know the OBgyns are notorious for long appintment waits. That's awesome that your cycle has returned to normal! That's crazy, cause, I was told to expect a while before I would ovualte and get my period after stopping, but I got it right away too! I've been off for a month. But, b/c I was on the Nuvaring-apparently-you can try much faster than some other forms. My GYN said as long as I'm ovulating and getting my period I could try now.

The meeting was great-first my husband and I just talked with her. She took a general gyn history. Then she told us that the category I fall into is the low-medium level risk. Talked to us about trying to conceive-she suggests charting also, and using the ovulation kits. She also said to not have intercourse 2 days before I ovulate-so the sperm count doens't go down.

The concern that came up for me was-she said the most common complication for the body type I fall into would be premature delivery. And to prevent that, bed rest. That's about it. So that will be hard for me to rest-I hate messes and chaos! But I'll have to. She explained why the body goes into premature labor, how the oxygen level in the blood goes down, the baby gets most of the oxygen, etc..And the lungs can't take it, so the uterus contracts b/c of being pushed on. The thing was too-I always though that premature meant major major danger. But its not anymore-as long as you carry to 30-32 weeks at least. The baby will be fine. There's just a higher chance of needing a c section, b/c the at 30 weeks the fetus' head isn't developed enough to take going through the birth canal.

As far as my wishes-the main was, I want to try first for natural vaginal delivery. If possible. I'm not going to plan on drugs or c section if it's not required. I'm also not going to rule those out-if a serious need comes up.-Like breathing wearing me out and needing drugs b/c of serious exhaustion. But, she was happy to work with me, as long as I remain reasonable too.

The other was, as a Jehovah's Witness I won't take blood transfusions, and she said that all my wishes we be taken care of, and the need for a tranfusion is so slight in this case-it won't be a problem. She was very respectful of our veiwpoints, and said all she wanted was for us to have open communication and be comfortable with each other.

My other question was did she have a problem if I wanted a Doula or other form of birth coach present? She said not at all, as long as the coach and her have met, and are on the same page, and there is open communication. In other words, at delivery, there's no disagreement in the delivery room between the two. She did encourage that my my hubby and I take classes, and he learn the coaching, b/c it increases the intimacy between us. So, we may look at that apporach instead.


The other thing that impressed me with her was she will be there through the whole labor and delivery-so she'll be there to answer all quesitons, and coach me. Tell me what to do and when. Not like some other docs who show up just at delivery time.

This OB has many patients with respiratory problems, but she isn't exculsivley that. She's a general OB. But, b/c of the connection with the CF center and St. Vincent's hospital, she has this repuation as now being a specialist in this field. So in general terms-the office is not loaded-by any means-with cfers or sick women. But, in her field she has much more experience with lung complications. My Cf doc sends all her patients to her b/c she just has so much experioence with dealing with these special issues. She is also willing to work in close connection to my Cf team-they talk to each other alot. And my cf team will be able to be involved in my labor and delivery too b/c of the relationship.

What I loved about her mostly was how inteligent she seemed, how important positive thinking is to her, how she wants us to feel completely comfortable with her and be open. I hate whe youre' trying to express yourself to a doctor and you get rushed in and rushed out.

That was a mouthful!!! I hope this helps a little! Congrats on your news too! I all goes well with you.

 

[LouLou]

Christian and others... yep I'm full of questions... better that than BS right?!

<div class="FTQUOTE"><begin quote><i>Originally posted by: <b>Scarlett81</b></i>
My GYN said as long as I'm ovulating and getting my period I could try now.
<b>any mention of getting pregnant but it not 'sticking' because of progesterone levels being off due to birth control?</b>

Then she told us that the category I fall into is the low-medium level risk.
<b>Any idea how she came to this conclusion? metric?</b>

Talked to us about trying to conceive-she suggests charting also, and using the ovulation kits. <b>she mention basal temp. charting and/or cervical mucus? I wonder if any of her CFers have ever successfully been able to analyze their mucus...this is a challenge for me.</b>

She also said to not have intercourse 2 days before I ovulate-so the sperm count doens't go down.
<b>then to have sex of day of ovulation or still refrain?</b>

es into premature labor, how the oxygen level in the blood goes down, the baby gets most of the oxygen,
<b>she talk about the chances you'd need supplemental O2? Have you ever had your night time O2 level checked?</b> e

As far as my wishes-the main was, I want to try first for natural vaginal delivery. If possible. I'm not going to plan on drugs or c section if it's not required.
<b>Did she talk about trying to avoid c-section due to the fact that it would make it much more difficult for you to clear your lungs? C-section is one of my greater fears to do with pregnancy - I've got to be able to cough..</b>

The other was, as a Jehovah's Witness I won't take blood transfusions, and she said that all my wishes we be taken care of, and the need for a tranfusion is so slight in this case-it won't be a problem.
<b>I'm sure they can take some blood of yours to transplant back into you unless JW's are against that as well - definitely good to talk with her in advance about. I'd be interested to know does this rule out organ transplant for you?</b>

The other thing that impressed me with her was she will be there through the whole labor and delivery-so she'll be there to answer all quesitons, and coach me.
<b>That is the coolest thing you've said through this whole post</b>

This OB has many patients with respiratory problems, but she isn't exculsivley that. She's a general OB. But, b/c of the connection with the CF center and St. Vincent's hospital, she has this repuation as now being a specialist in this field. So in general terms-the office is not loaded-by any means-with cfers or sick women. But, in her field she has much more experience with lung complications. My Cf doc sends all her patients to her b/c she just has so much experioence with dealing with these special issues. She is also willing to work in close connection to my Cf team-they talk to each other alot. And my cf team will be able to be involved in my labor and delivery too b/c of the relationship.<b>definitely an eye opener</b>

What I loved about her mostly was how inteligent she seemed, how important positive thinking is to her <b>this is something that is so important to me and I'd never thought about evaluating a doc. on this trait but definitely a great idea thanks!!</b>

<b>Great !! and thanks for sharing the details - I hope my questions aren't too prying.</b>

 

[JazzysMom]

CHristian.....Was she Dr. Sondry? The one that delivered Jazmine? I think that is the spelling. Very gruff, but great like I told you!

 

[Momtana]

Christian, I used the mucus method for birth control for many years; for me the CHANGE in the mucus (from increasing levels of estrogen) around ovulation was noticeable. Look for clear, wet, stretchy mucus - it may be a lot or a tiny bit - Also, follow your libido! = )

 

[Scarlett81]

Melissa- Yes is was Dr. Sondhi. Of course, I didn't mention you-confidentiality and all that!<img src="i/expressions/face-icon-small-smile.gif" border="0"> But I got what you meant about gruff-I would say, she gets down to business. No lah dee dah nonsense. And I can tell that if she feels you are not healthy enough to be doing this, she'll tell ya what she thinks. But as I said-so far I LOVE her. LOVE LOVE LOVE her.

Momtana-thanks for the tips, I've been reading a book all about charting cervical mucus-fascinating stuff.



Originally posted by: Scarlett81 /Lauren:
My GYN said as long as I'm ovulating and getting my period I could try now.
<b>any mention of getting pregnant but it not 'sticking' because of progesterone levels being off due to birth control? </b>
sorry, no.

Then she told us that the category I fall into is the low-medium level risk.
<b>Any idea how she came to this conclusion? metric? </b>
based on my lung function being very high right now (pfts), my last year of lung function and amount of exacerbations, my weight, the fact that I've never had weight issues, and my cepacia is under control.

Talked to us about trying to conceive-she suggests charting also, and using the ovulation kits. <b>she mention basal temp. charting and/or cervical mucus? I wonder if any of her CFers have ever successfully been able to analyze their mucus...this is a challenge for me. </b>
sorry can't help you-but I know some women on this site that have charted their temps, and there are some great books about it

She also said to not have intercourse 2 days before I ovulate-so the sperm count doens't go down.
<b>then to have sex of day of ovulation or still refrain?</b>
When you do the home urine ovulation test-it shows that the LH surge is present-that means that 24-36 hours from then, you will begin ovulation. So, you have sex 1-2 hours after you get a positive LH surge test-b/c even if you don't ovulate at that exact time-you will in the 24 hours or so, and the sperm can live inside you for days. So have sex then-and then skip sex the next day, and do it again the following day. That way you give your hubby 24 hours for his sperm count to go back up and replenish itself. EX: You test with urine strips every day-finally on a Monday it is positive at 8:00 AM. Have sex by 10:00 AM, skip the next day, and do it again Wedneday morning. This is what my doctor said.

es into premature labor, how the oxygen level in the blood goes down, the baby gets most of the oxygen,
<b>she talk about the chances you'd need supplemental O2? Have you ever had your night time O2 level checked? e</b>
I haven't actually ever need O2 supplement at night or day. I don't remember if I've ever had it checked. I'm sure I have-I've been admitted enough. She said that sometimes supplement O2 is needed, but you won't know that until that moment arrives. You just can't tell that ahead.

As far as my wishes-the main was, I want to try first for natural vaginal delivery. If possible. I'm not going to plan on drugs or c section if it's not required.
<b>Did she talk about trying to avoid c-section due to the fact that it would make it much more difficult for you to clear your lungs? C-section is one of my greater fears to do with pregnancy - I've got to be able to cough.. </b>
She did say that she wants to avoid c section at all costs-b/c I need to recover my lung function asap after birth. and the scar makes that very hard to do, like you said. so that is usually her last resort.

The other was, as a Jehovah's Witness I won't take blood transfusions, and she said that all my wishes we be taken care of, and the need for a tranfusion is so slight in this case-it won't be a problem.
<b>I'm sure they can take some blood of yours to transplant back into you unless JW's are against that as well - definitely good to talk with her in advance about. I'd be interested to know does this rule out organ transplant for you? </b>

Witnesses do not take blood transfusions of any kind, including our own. This conflicts with our bible based beliefs. But, she explained that at the time of pregnancy a woman's blood volume increases by 50%!-So a woman can afford to lose alot of blood during birth. And she has never seen a need for any type of blood transfusion during birth. As far as organs, like lung transplants-this is left up for a Witness to decide based on how they personally feel. There are many hospitals in the US that specialize in bloodless organ transplants-and I would feel completely comfortable receiving an organ transplant if I needed it. There is a bloodless organ transplant center in NYC and Philadelphia, Englewood, New Jersey, and there are several that I know of in Europe as well. Many more exist that I just don't know of. So, it's rarely an issue these days because medicine has come so far to accomodate us.


The other thing that impressed me with her was she will be there through the whole labor and delivery-so she'll be there to answer all quesitons, and coach me.
<b>That is the coolest thing you've said through this whole post </b>
I think so too.

This OB has many patients with respiratory problems, but she isn't exculsivley that. She's a general OB. But, b/c of the connection with the CF center and St. Vincent's hospital, she has this repuation as now being a specialist in this field. So in general terms-the office is not loaded-by any means-with cfers or sick women. But, in her field she has much more experience with lung complications. My Cf doc sends all her patients to her b/c she just has so much experioence with dealing with these special issues. She is also willing to work in close connection to my Cf team-they talk to each other alot. And my cf team will be able to be involved in my labor and delivery too b/c of the relationship.<b>definitely an eye opener </b>

What I loved about her mostly was how inteligent she seemed, how important positive thinking is to her


<b>this is something that is so important to me and I'd never thought about evaluating a doc. on this trait but definitely a great idea thanks!! </b>
<b>Great !! and thanks for sharing the details - I hope my questions aren't too prying. </b>

-------------------------
Lauren

27wcf



Back to me: No problem Lauren-your questions aren't prying at all-why should I go through all this and not try to help others and share what's happening to me? If you think of anything else please don't hesitate to ask!!, Christian

 

[LouLou]

thanks Christian!