Monday, October 12, 2009

High Risk

I didn't know what to expect this morning but it turned out really well.

First, they completely redid my u/s. Really wasn't expecting that. I thought I would just have a consult with the dr. and he would look over my my last u/s report and send me on my way. It was so much more than I was expecting. I told my husband not to come because I didn't think I'd have a u/s so he was at home, although I'm sure he would have liked to come (he's still not allowed at dr. appointments with me after his unwanted contributions last time he came with me to the old ob).

The baby looked fine. He was actually head down already. The tech said that sometimes they like being head down and will stay that way and sometimes they don't at this point, so we will see. He only measured about a week ahead (weight was 1lb 11oz) this time, but still fine. He was really cute on this u/s and and was a lot easier to follow where she was and his position and what he was doing. We saw him open his mouth a couple times and put his fist up to his head. We also took another look at his 'pee-pee'. Definitely still a boy.

Then a nurse came in and got a fairly detailed history from me. And then I moved to a small consult room and waited for the Dr. (By the way, this was the nicest dr. office I have ever been in, bar none. I thought RE's had fancy offices, but this blew that away.)

He came in and we talked. He thinks everything looked good but he still wanted to put me on a high risk schedule. I was surprised that he would do that and he said that he offers it pretty standardly for patients that have been through infertility and also have PCOS since both of those put you at a higher risk for complications, but also because of the HETEROZYGOUS MTHFR (that's right, he was surprisingly concerned about the hetero MTHFR even though a great deal of the population has it and most people don't worry about it as a complication).

I'm not sure what all is involved with a high risk schedule, but on top of my regular appoints with McSoothy I will see him and my next appointment is in a month and we will do another u/s at that time, I think. And then I will have weekly biophysical profiles from there on out plus more appointments with him. I will be a busy girl.

He described PCOS in a different way than I have ever heard a Dr. talk about PCOS. He said it is really, at it's heart, an inflammatory problem and should be treated at such. (Anyone else ever had it put to them like this?)

For instance, I've always wondered if the baby aspirin made the difference with getting pregnant, he thinks it probably did since it helps with inflammation. AND he wants me to stay on it the WHOLE time (everyone else told me to quit at 35 weeks). He's not concerned and says you really only need to quit if you're on heparin too or if the anesthesiologists are really picky at your hospital. I'm hoping for a natural birth, so hopefully this won't be an issue, but it will be good to know that I can safely get an epi if I need one.

He also wanted me to increase some of my supplements. McSoothy called me in extra folic acid, he said that was good and to do 5mg per day (on top of my prenatal). I take a 300mg vegan DHA supplement and he wants me to triple or quadruple it! Now, those stupid pills cost me at $30 per month, so I think I will only triple it, cause that's pretty expensive. And he wants me to add 1,000 IU of vitamin D on top on my prenatal. So, I will be popping a lot more pills now. (By the way, this is all standard for his patients, he had little neon pink cards sitting in the consult room with all of this on it and made sure to check all of them for me).

I'm also suppose to start kick counts which I figured was coming. I also got my thyroid drawn since it's been awhile and I was going to ask someone to check if no one offered it soon... that's a pretty important one.

He was very complimentary to me. He really praised me for being proactive and he made me feel really good about being there. I really liked his whole office. And I'm not sure if all of this is overkill or not, but it feels good that someone is interested in my pregnancy like this. The goal is a healthy baby so hopefully this is just helping to improve the odds.


Sophie said...

Sounds like this guy knows his stuff. I've never heard of PCOS referred to as an inflammatory problem, but I wouldn't doubt it. I also didn't know that about PCOS/high risk... well, not entirely. Like I said, it really sounds like you're still in good hands! I bet the ultrasounds where the baby's moving are extra exciting... can't wait for those!

Anonymous said...

Hey, I've been tracking your progress and now I have to ask the stupid question... What is HETEROZYGOUS MTHFR I truly don't know, sorry. By the way, I loved your belly pic last time!

Amanda said...

MTHFR is short for Methylenetetrahydrofolate Reductase. It causes a reduced ability to utilize folate which can be bad for pregnancy (neural tube defects) as well as cardiovascular health and blood clots and probably other stuff too. Their are 2 basic types, heterozygous or homozygous. Hetero means I have the MTHRF mutation on one gene (and the other is normal) and homo means it's on both genes (this is the more severe problem). Lots and lots of people have it hetero like I do, so that's why I'm surprised that he was concerned with it.

I guess the verdict is that I can still have problems even though I only have hetero and that's why they want to address it with the extra folic acid and baby aspirin, but it's less likely that the problems would be severe.

wannabmomma said...

Glad to hear the doctor will closely monitor you. I didn't know we PCOSers are "high risk". Sounds like he's a good doc! And no, I've never heard it referred to as an inflammatory problem either. Nothing would surprise me though.

Celia said...

I am so glad you and the baby are getting well taken care of.

Mary said...

I have hetero mthfr and pcos too. I had 3 chemical pregnancies before I started taking baby aspirin daily and then this pregnancy stuck. Coincidence? Maybe. But, I'm still a firm believer in ba.

Michelle said...

Sounds like a great appt. You have some really great doctors!
I haven't ever been told that about PCOS, but I was told by the RE for the study that I'd be classfied high risk at first till they feel comfortable with a transfer. And I have a friend that also has PCOS and is dealing with a lot of high risk drs with her pregnancy. Just gives me more questions for my appt!

Anonymous said...

I am way behind on commenting, but I had to come back and comment on this. Your high risk doctor sounds amazing! I wish I lived nearby so I could go to him. I have had really bad luck with doctors. I am so glad that he is being so proactive with putting you on a high risk schedule. I wish I had that just for the reassurance! I am so frustrated, because I live in a city of a million people, with a supposed great health care system and medical school, yet I can't find a doctor who even seems to understands pcos at its core. I am happy that you have found a good one!
And thank you, by the way, for being so supportive of me. I'll post soon to give an update on what is going on, but I really appreciated your comment on my last post. It helps so much to have great bloggy friends to lift you up when you've been kicked in the face by yet another idiot doctor.