There are no exciting pictures to share. The only thing I brought home from my appointment were feelings of being overwhelmed and general disappointment towards what has become of our health care system.
As I said, in my 2.5 hours there, I got a pap smear and a breast exam. My (extensive) health history was input into a computer system. The doctor ordered a bunch of labs for me, and then I had to explain that I had most of them done during my testing for IVF. So, we paged through those lab forms to find the tests. The doctor talked me into having him order genetic tests on me for SMA and CF (Spinal Muscular Atrophy and Cystic Fibrosis, both genetic disorders) that I really didn't want because I didn't think my insurance would cover them (plus, my husband had gotten those tests in the fall before IVF and he was negative, and to have an affected child, both parents need to be positive, so really there's not point in running them on me). The doctor assured me they are both apart of routine prenatal testing. So I called my insurance when I got home, my insurance said to cover them they needed documentation of medial necessity and I have learned by now that this means a huge headache and usually a bill for me, although I have no idea what that bill would be. So, now I have to go back to have them cancel those tests (sigh).
If I may, as a recently frequent consumer of American healthcare, I would like to say our system is awful. In what other industry does the consumer not really have a choice over what they are "buying" but then there is no way of finding out a price until after the item is "bought". It would be like going to a clothing store with a no-return policy, asking how much something was, and the cashier saying that you can only find out the price if you buy it, but no returns. So perhaps I'd find myself spending $300 for a t-shift that I NEVER would have bought had I known it was costing me $300,especially if the t-shirt wasn't 100% necessary for me. That's how I feel about some of the testing I've had done. For example, I haven't had an HIV test in 6 months. So they want to do one again. Since I've been married, I've had about 4 HIV tests. Not surprisingly, they are all negative. It kind of makes me mad that considering I am neither sharing needles nor do I have multiple sexual partners that they can't go ahead and say the test is valid for an entire year or maybe even two! Forget that fact that this test is covered by insurance, it's still costing SOMEONE money and it's not a prudent use of healthcare dollars. What is our obsession with ordering tests after test that are logically not needed? But I digress.
I have decided that for the most part, medicine and practices are what they are. I was not asked once how I was feeling or what symptoms I had. I wasn't really counseled on what to avoid other than "sleeping on my back" because I will get bigger faster, and was handed a info packet on pregnancy. I did hear a few "Congratulations" from people in the office so I guess that was good. My time with the doctor was mostly spent filling in the blanks of an electronic chart and tediously going over how I had thyroid cancer.
As for why I am overwhelmed: multiple things. First, because I am carrying twins, I am going to be seen every 2 weeks at my regular OB and then probably every 4 weeks at a perinatologist, which is a specialist for high risk pregnancies. They need to do ultrasounds to make sure the babies are growing at the same rate. I will also need to continue to get blood work every 2 weeks to check my thyroid levels, so I need to make an appointment with my endocrinologist to get orders for this. I also need to make appointments with Quest because they don't draw blood work in the office. Also because it's twins, I can only been seen by a doctor, not a nurse practitioner. I would say that's fine, expect it's very hard to get an appointment with a doctor at a decent time and I was warned that I should be prepared that they are running behind. I am actually thinking about switching practices (already) but I honestly don't know if another practice would be any different.
I did get to ask him briefly about vaginal vs. Caesarean section birth of twins. Basically, both babies have to be in head down position to attempt vaginal. If one or both were breach, they would recommend a section. I am fine with either way and it will be interesting to see what my "birth experience" ends up being. About 30% of all births now are c-section so I guess most OBs are very practiced at that surgery.
So, I have lots of phone calls to make. My top priority is to try to get in the with the perinatologist so I can see my babies again! I am excited to get some of the first semester screening over with but honestly I know that this pregnancy is going to be incredibly time consuming. While I am so so happy to be pregnant with our two babies and I am VERY used to spending a lot of time in doctor's offices, it doesn't make it less daunting for me. Having so many "issues" means seeing a lot of different specialists. I need to do my very best to schedule all of these appointments outside of work time. Any work time I miss comes straight out of my 12 weeks of FMLA maternity leave, which is very precious to me. I am just a bit overwhelmed but will try do keep myself focused on what matters- having 2 healthy babies in November.
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