Putting The Pieces Together

TTC #2

First Prenatal Visit November 3, 2009

In some ways my first prenatal visit was a boring bureaucratic task. I had to meet my doctor in a different office than usual where they do OB intakes, even though I’ve had this doctor ever since I found out I was pregnant with my first son and she is now also my son’s doctor. Since my medical history is already in their system, she really had nothing more to do than to estimate my due date based on my last menstrual period and then send me to the lab to get blood drawn. And yet I was at the doctor’s office for two hours. So yes, it felt a bit silly and formal. But it was also a big deal because it was the first official visit of what will be many visits over the next months.

My son and I arrived at the appointment early for once in my life. Because there’s a public transportation strike right now I had to walk, and since I was going to a new office location today (just a few blocks from where I usually see my doctor), I actually left myself a lot of time to get there. I had originally debated about bringing my son because I thought I might be having an exam, but I had emailed with my doctor and she told me that this was just a talking meeting. Also, I thought he needed to get the second dose of the flu shot (but it turned out he’d had the first dose too recently and so they couldn’t give him the second one yet).

My appointment started off with a nurse taking my blood pressure and then sending me to the bathroom to leave a urine sample. Then my doctor came in and asked for the date of my last menstrual period, and I actually had to look it up! I had been remembering the date that I had guessed that I ovulated, which is sort of silly since I really don’t know for that month. (Of course, after four months of charting, I get confused on the month I get pregnant.) I had been estimating the due date as June 25, 2010, but she estimated June 21.

She then asked whether I wanted to do an ultrasound. I paused and said, uh, you mean right now? No, she just meant an early one for the purposes for getting an accurate date. I paused again and said, is there any reason I wouldn’t want one? She laughed and said no, that it’s just that some people are purists and don’t see any need to peer inside any earlier than necessary. But I think I am like most people who think that the sooner I can see the baby, the better! So she wrote me a prescription (or a script or whatever they call it) for an ultrasound which I can schedule whenever I want.

Then she also wrote me out a prescription (or a script or whatever) for a VBAC consultation / AMA visit. The VBAC consultation part is a meeting with doctors who will review my previous labor and emergency c-section to assess what happened and to advise whether they recommend a repeat c-section or whether they think I can try for a VBAC. I have enough thoughts on this to write another whole post on the matter, for now I’ll just say that I really wish they offered this kind of consultation as an immediate follow-up to having had a c-section. I know I am not alone in feeling like the c-section took me completely by surprise, left me feeling really scared and nervous about the possibility of having to have a second one, and to this day, I still think about it and wonder what I did wrong (if anything) and whether they did the right thing! So finally, almost two years later I finally get to talk to someone about it.

The AMA part of the consult refers to Advanced Maternal Age, referring to the fact that I am 35. The doctors I’ll meet with will give me risk ratios for things like Down’s syndrome and discuss a bunch of diagnostic tests that I can choose to have (or choose not to have), like a blood test, an early ultrasound, and/or an amniocentesis. I think it’s fantastic that I’m actually going to be able to talk to someone about this instead of just having a bunch of pamphlets thrown at me and then asked to make some decisions. I really don’t know whether I’ll have these tests or not. I didn’t have them done with my son (and that was when I was 33 turning 34 before he was born), so I’m sort of leaning against them now. But, I honestly haven’t thought through this very much and I think that this really warrants some serious thought. So I will start to scour the internet for information and listen to what the doctors have to say and decide after that.

Next on the agenda was the flu shot. They handed me some papers to sign and I saw that they intended to give me the regular flu shot and the H1N1 flu shot. As I was distracted and talking with my doctor, I signed my name next to both of them. But then when I was left in the room for a minute by myself before getting the shot, I thought, wait, didn’t I already get the flu shot? And yes, I did, as my doctor confirmed in my records. So I’m glad one of us was paying attention!

As for the H1N1 vaccine, apparently my doctor’s office got 20 doses which they split between the two office locations, and there was only one left at the current location and I got it! I’m a little relieved, because the more I hear about the flu and particularly pregnant women getting the flu, the more concerned I was getting.

Finally, my doctor ended our appointment with some distressing (to me) news. In a few months, she is going to be leaving the practice! It’s a good move for her because she’s going to work somewhere where she doesn’t have to work nights and weekends all the time, 48 hrs at a stretch. Apparently they just don’t have enough OB doctors in this practice/hospital, so they are all stretched too far. I never would have guessed because my doctor has an incredibly warm and bubbly disposition and she is always available to me by phone or even email. But anyway, it’s gotten to be too much for her and she said that she would like to be able to have a baby one day herself, so it sounds like this is a good move for her. Of course, that means I will be finishing up this pregnancy without her and will need a new doctor for myself and for my son. I actually got kind of teary when she told me, which is probably in part because I’m already quick to cry these days. Hopefully she took that as a compliment and not as a needy/deranged patient! She told me that she can recommend a couple of people to me, one of whom I met when I was in labor last time (of course, I can’t say I got a chance to assess him with a clear mind). So we’ll see. My husband has also suggested that I could try other practices in the area and/or get a separate pediatrician for my son (and future child).

The rest of the visit was just a lot of waiting. We waited and waited for me to get blood drawn. And when they finally called me, I had to leave my son in the stroller and he started crying! He’d been fine when I was entertaining him, but when he was five feet away from me and I couldn’t move to get him, I think he just freaked out. He was tired from not having a good nap and he was almost certainly very hungry because this visit took so much longer than I’d expected. It’s also possible that he was freaked out about the needle going into my arm – maybe he remembers the couple of times he’s had blood drawn. (Both attempts failed and he was miserable and they’ve recommended I bring him to the children’s hospital because they have smaller needles, more experience with young children, etc.)

Then we waited some more for his flu shot, only to find out in the end that he’d had the first dose too recently and so they couldn’t give him this second dose. At that point I was shoving Cheerios in his hands and he was crying for more and I was just eager to go home. I have to say I am very glad he didn’t get the shot!

Then I came home, couldn’t deal with cooking dinner so late, we ordered Chinese, I made a big deal about how I didn’t want what we usually ordered and instead wanted tofu, and then when the food got here and I ate two spring rolls, I decided I was much too full for the soup or the tofu! Oh well, I guess I have dinner for tomorrow night now.

 

Focusing November 3, 2009

Filed under: Early,Pregnancy — puzzlepeeces @ 12:38 pm
Tags: , , , , , ,

Since I’m only in the first trimester, I feel like this pregnancy should be backgrounded in everything I do. In fact, I should not only be focused on work, I should be putting in double effort because all too soon I will have to tell my bosses, and then there will be the brain fog of the third trimester, and then maternity leave of some sort. (At work, I am not under a contract and as far as I understand, my bosses’ could let me go whenever they want – though presumbly with at least 3 months notice or so.) I really thought that when I got pregnant, I would instantly snap into overdrive.

But instead, two things have happened. One is that I’ve been really focused on this pregnancy, wanting to read about it (e.g., I’m rereading the Girlfriend’s Guide to Pregnancy) and finding myself thinking about it all the time. And I don’t know if this is nesting already, but the state of our apartment fills me with anxiety – it’s a mess now and I can only imagine how out of control it will be when this baby gets here, even though it’s still months and months away. So I’ve been trying to clean, but of course, when I clean one area, I usually just make another one messy.

The other thing that has happened is that I’ve been feeling some fatigue and nausea. It’s not enough for me to be outright sick, but it’s enough that I feel a little draggy, I want to watch tv when I get home instead of rushing around making dinner, and I keep going to bed a little early. And my digestion system has really slowed down, making me always feel a bit uncomfortable and slightly nauseous. I wouldn’t say I’m bothered by certain foods, but I am a lot less interested in food than I was last time. Last night I made macaroni and cheese for dinner and just couldn’t bring myself to eat any of it myself. Instead, lately I’ve been on an egg kick. But I supposed that just for general health reasons alone I probably shouldn’t keep eating two eggs over easy on toast for breakfast and dinner!

The idea that I should be doubling my efforts at work is still with me, but instead of acting on it I’ve just been feeling slightly guilty and anxious about it. I also feel a little bit like I’m waiting for this tired queasiness to pass. Of course, that is unrealistic thinking. Just because I feel a little under the weather and normally that would pass within a few days at most, this is quite likely to continue for at least two more months. So I think what I need to do is find a good balance between rest and work. When I’m at work, I can’t work slowly just because I’m a little tired. I need to push through and get as much done as I can, knowing that I can relax at home. (I actually should be working at home as well (because my job is one that isn’t really supposed to be done in only 40 hours a week), but for the sake of balance, I probably can get away with resting in the evening if it helps me be more productive during the day.

(Of course, I’m talking like I don’t already have a child who requires time and energy!)

But today is my day home with my son. This is in part to avoid paying child-care every single work day and also in part to give me a day home with him so I don’t have to go five days in a row without spending time with him other than in the evenings (half of which I’m supposed to be working). So I’m going to spend the rest of today reading with him, playing with him, making lunch, cleaning, etc.

Also, I have my first prenatal appointment today. My doctor says there won’t be an exam, so I’m guessing it’s just filling out some paperwork, figuring out the due date, and getting the swine flu shot (they have only 20 doses left in their office, reserved for pregnant women!). But who knows, maybe something more exciting will happen. (I’m secretly hoping to hear a heartbeat.)

 

 
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