Stella's Birth Story

The way my daughter entered the world wasnt how I pictured or envisioned it. She arrived safely and was screaming within a few seconds of her birth, but I can't say I was prepared for how everything would unfold.

It all started on Thursday October 1st. I woke up feeling similar to how I'd felt all week; super nauseous and exhausted. I planned to take the girls to story time at the library at 10:30 and my mom was going to join. Sometime during the morning I went to the bathroom and when I wiped I noticed I was losing my mucous plus. Since I was already feeling super nauseous it actually made me gag and throw up. 

Not feeling much different (maybe a little more crampy) I stil decided to go to the library. My FiL also met us there and my mom rode with me. When we arrived Clara wanted nothing but me. She was crying and carrying on so I carried her some. At 39+ weeks pregnant I was struggling with carrying her. 

After the library we headed to the bakery for donuts. Once again, Clara was just inconsolable unless I was carrying her. In pain, I carried her the four or so blocks it took to get there. I was seriously ready to cry it was so uncomfortable, but we made it. At that point I still hadn't had anything to eat so ordered a smoothie and managed to have about 2/3rds of it. I was still feeling really nauseous. 

After lunch Lucy refused her nap. She cried and carried on for nearly an hour as I begged her in my head to go to sleep so I could also get a little rest. I was exhausted and defeated and wasn't able to really take care of myself. I didn't eat much of a lunch and was feeling so stressed from my day with the girls. 

When W arrived home I was so grateful. I'd been feeling crampy and having lots of pressure and was glad he was home to take over with the girls. Around that time I texted our doula Jen to tell her I had lost my mucous plug and that I was feeling really crampy. 

Since the girls continued to be cranky we decided to take a walk. It was a beautiful day so it seemed like a good idea. As we walked I felt more and more contractions and started tracking them on my phone. They were about 10 minutes apart at that time. Clara ended up throwing another huge fit on our walk as she didn't want to be in the stroller and only wanted to be carried. It was exhausting to say the least. 

We got back and had dinner. I still wasn't hungry so didn't eat much. The contractions and cramping continued pretty consistently but we still did baths and put the girls down for the night. I again texted Jen to tell her things weren't really slowing down and to give her the heads up. 

As the evening progressed the contractions weren't stopping. I bounced on my ball, relaxed as much as possible on the couch, and then decided to take a shower. I made W come with me to keep track of contactions while I was in the shower and because for some reason I didn't want to be alone. 

Around 10:30 I called my drs office. I spoke with the one dr I hadn't met yet (Dr. B) and she suggested I go to the hospital to get checked. She also said I could skip my evening Heparin injection. It didn't feel like we really needed to go in at that time so I texted our doula. W made me a quesadilla and I was able to eat that. It was one of the few things I ate all day. At 11:30 we asked Jen to come to the house. A little earlier we had told my FiL to also come to stay with the girls.

The doula arrived about an hour later and I labored at home for quite some time. Since it was a VBAC Jen suggested that at around 1:45 am we leave for the hospital. My contractions were regular and I was unable to talk or rest much during them. Jen helped to get me situated in the car and suggested I lay down in the backseat rather than ride in the front. She followed behind us. 

The car ride felt really long. I tried to stay calm and relaxed, but it was difficult. It took us about 35 minutes to get there. The final turn to the hospital corresponded with a huge contraction and I remember that feeling like the hardest part. 

We arrived at the hospital around 2:00 AM and they took me to triage on the labor and delivery floor. The first contraction I felt I tried to get onto all fours, but the nurse yelled at me and told me I needed to lay back so she could get me hooked up to the monitors. I was a little shocked to say the least. A resident checked me and I was 4 cm dilated, -2 and 70% effaced. They said they'd call my Dr and come back to let me know the plan. My dr decided to admit me and at 4 AM they drew my blood. By 4:30 I was in a room and hooked up to monitors. I had no idea how awful those monitors would be. 

For the next few hours I labored in the room. I rested, bounced on the ball, labored on all fours, walked, and tried anything else our doula suggested. At 5:30 AM Dr. B checked in and told me there was no need to check my cervix again unless my water broke or I felt the urge to push.

At 7 am the nurses switched and somehow I got two nurses assigned to me. By 9:15 I found out the Drs also switched shifts and Dr. L came in to see me. She wanted to check me and I agreed. I was 5 cm dilated, still -2, and 80% effaced. Around that time my contractions slowed so we tried walking. I can honestly say that there wasn't a 10 minute timeframe during my whole labor where the nurses didn't come in to mess with and adjust my monitors. The most comfortable position I found was folded over, yet any time I'd get in any variation of this position the nurses would come in and insist on adjusting the monitor. I don't think there's anything more unpleasant than strangers touching, poking, pushing, and tightening two belts around your waist while you're contracting. I would beg them to let the contraction end before touching me and pushing on my belly, but they never listened. Even if I was sitting on the toilet they'd come in and insist on making their adjustments. I didn't want to really be touched at all in labor and to have strangers doing it every few minutes was really unpleasant. I really feel like this impacted my ability to relax. It's hard when there are tight belts around your waist and people constantly in your face messing with them. Not to mention, any comfortable position was out since the monitors couldn't pick up a signal when I was in them. Being upright, walking, or in bed were the only reliable positions to pick up the signal. As a result I did a lot of laboring leaning on W or Jen and  basically slow dancing. I didn't realize how great it would be to have a doula who was short like me because she was the perfect height to lean on during contractions.

Around 12:30 pm they suggested the whirpool tub and I agreed. Jen left to get herself some food and I labored in the tub. They really only let me stay in the tub for about 20 minutes before they asked me to go back to my room so they could get me back on the monitor. While I was in the tub we used wireless monitors. The tub was nice and seemed to help me relax, but once again the nurses were in the room every few minutes and I wasn't allowed to stay in very long.

Around 1:30 PM Dr. L wanted to check me again. At that point I was only 6 cm dilated and still -2 and 80% effaced. She wasn't very encouraging about my lack of progress so at 2:30 I tried walking again.

At 3:30 PM a hospital midwife came in to see me. I remembered her from Lucy and Clara's birth and also knew she delivered one of my friend's babies. She commented on how exhausted I seemed, how she could smell ketones on my breath, and how I seemed to need a little push to get things moving again. My contractions had started to space out and she said we needed to get them closer together to get things progressing. She was worried about my level of exhaustion and dehydration and suggested we start IV fluids and a bolus. I was so exhausted and didn't want to hear what the midwife had to say. She wasn't super optimistic about things and really focused on my level of exhaustion. The whole time I was in labor I was so afraid of feeling more nauseous and vomiting that I wasn't able to drink much water. I wasn't allowed to have any food. Jen offered me a drink after every contraction and I would take little sips, but my body needed more. It was obvious by the ketones on my breath.

At 4:30 PM I finally consented to start the lowest dose of Pitocin (2 mg) in order to help things progress. I really feel like this was a turning point and wish more than anything I would have made a different decision at that time. I was just that Dr. L and the midwife made valid points. I was so exhausted I started to fear I wouldn't have the energy to push my baby out. I remember talking with Jen and her saying pushing would feel different because I would be more active rather than passive like getting through the contractions.

Little to my knowledge, the pitcoin got turned up every half hour. No one asked, no one told me, and I had no idea. All I know is that I went from feeling like I could stay on top of and ahead of my contractions to feeling totally out of control. Jen had told me to picture each contraction as a wave and myself as surfing those waves. To picture myself staying just ahead of those waves in order to stay on top of them. Things got so intense so fast and I had been laboring for nearly 24 hours. It was amazing to me the difference between natural contractions and contractions on Pitocin. At 6:30 the Pitocin got increased to 6 mg and by 7:00 PM I was asking about pain relief. I debated the narcotic pain medications but after a few more contractions I asked about the epidural. When the dr told me the anesthesiologist could be there quickly, I told her that's what I wanted.

At 7:00 PM a new nurse also came on. At 7:30 my water broke in a huge gush as I stood up to lean on Jen during a contraction. It was a really weird sensation and felt like a huge water balloon came out of me and gushed onto the floor. Jen happened to be right in the line of fire and her pants and shoes got covered in my amniotic fluid. She said since my fluid levels had been high that was likely why there was so much fluid. The Dr checked me agin and I was 7 cm dilated, and still -2 and 80% effaced. By 8:00 PM the epidural was in place. I couldn't believe the difference. I went from feeling totally out of control of my contractions to not even being able to feel most of them. It was absolutely amazing and allowed me to rest for a bit.

At 9:30 Dr. L came in to tell me that the baby was experiencing decelerations with each contraction. She started to seem concerned, yet let me try different positions. I laid on my left side and they came in to tell me it was still happening. They tried oxygen and switching me to my other side but the baby wasn't tolerating things. With each contraction her heart rate would fall to around 100 and take a minute or so to recover. I started to watch the monitors and I saw her heart rate falling. It wasn't recovering after the contractions and I watched the door waiting for the dr to come back. The dr checked me again and I was 8 cm dilated. It was at that time that she also discovered meconium in the amniotic fluid. I knew at that point it was likely over. The dr let things continue with the decels until 10:45 PM when she came in and said she strongly suggested a c section. We asked for a few minutes to discuss things, but I knew it was over. At 11 PM I consented to the c section and I was wheeled into the room at 11:50 PM.

When I got into the OR they upped the epidural and I started to feel really numb. I was so cold and shivering like crazy. My teeth were chattering so hard it made my jaw hurt. They brought W in at about 12:10 and Stella was born at 12:25. I felt lots of tugging, pulling, and it smelled really bad when they cauterized things. They didn't lift Stella above the drape, and instead brought her right over to be suctioned. It took a few seconds and then we both heard her cry. They put a diaper on her and gave her to W to hold skin to skin. It was then that I was able to see her little face. Originally they said I could do skin to skin but at some point that changed. To be honest, I'm not sure I would have been able to hold her because I was shaking so much. The anesthesiologist had a heater that he was blowing on me. It helped to warm me up, but didn't make the shaking go away.

When they brought me to recovery (around 2:00 am) the Dr came and talked to me. She told me that my c section was "exceptionally difficult" and that there were a lot of adhesions and scar tissue, especially on my right side. Her scrubs were covered in blood and she said it was a good thing it hadn't been a true emergency because she may not have gotten the baby out on time. It took her 25 minutes to get to Stella.

Our doula Jen stayed with us in recovery for a while and helped me get Stella to nurse. She is also an IBCLC and was very helpful. It felt super awkward to be reclined, but Stella still latched and tried for a bit before falling asleep.

What wasn't shared with me immediately after surgery was shared the following days. Dr. L came in the following day and reiterated the difficulty of my surgery. She also said my incision was "paper thin". I honestly had no idea what that meant at the time.

At one week I had a follow up to look at my incision. I saw Dr. L and we discussed everything. I asked for clarification and she said that when she opened me up I had a "window" and that had she poked with her finger she could have opened my uterus. 

The next day I messaged one of the others Drs in the practice on Facebook. She is the one who is in our local mom's of multiples group and who got me into the practice. I asked her about the "paper thin" description and she explained things further. Apparently I had a "dehiscence" or "window", meaning the muscle layer of my previous incision had separated. The uterus has three layers; the endometrium which is what we shed every month, the myometrium which is the muscle layer, and an outer thin mucousal layer. My myometrium was no longer intact and that's why my incision was so thin. My uterus had started to rupture and Stella's decelerations were a result and signal of that. 

The days and weeks following her birth have been difficult for me. I'm still processing things and having all the post-partum hormones certainly don't help. Each day I feel a little better and I know I'll be fine, but talking to friends, W, and our doula has really helped. I'm so grateful we hired Jen and that she was there to support me in labor. I honestly don't know how anyone labors without a doula. 

  I know that the most important thing is that my daughter is safe and healthy, but I can't say I wasn't disappointed and sad about her birth. Even though I wrote a birth plan in case of a cesarean section, I honestly didn't have an open heart and mind to that possibility. I changed OB's at 20 weeks, hired a doula, and educated myself about vbac via documentaries and books. I truly thought if I wanted it and tried hard enough it would happen. I wanted this experience to be healing from my last birth. Throughout my pregnancy I said the most important thing to me was that I be able to hold my baby when she was born. I didn't get that experience of holding my daughter on my chest immediately after she was born and I think I'll always be sad about that. 

On the other hand, Stella's birth was a much better experience from Lucy and Clara's. I was conscious, we both got to hear her cry for the first time, and W was able to hold her skin to skin. I held her in recovery and was able to nurse her within the first hour of her birth and she never left our sides. I labored for 29 hours surrounded by the love and support of my husband and doula, and gave birth to my beautiful daughter. I know that the Dr gave me the best possible chance for the vbac and also let the decelerations continue for quite some time before insisting on a cesarean. For everyone's health and safety it's best I had a cesarean. 

I'm so grateful to have another beautiful daughter to love and snuggle. It's been a difficult recovery physically and emotionally, but my heart is so full!

My first time holding her.

Nursing in the recovery room. 

Lucy meets her baby sister for the first time. 

Kisses from Clara. 

First family photo. Perhaps not our best, but its our first one all together. 

All my girls. 

Kisses for baby Stella. 

Proud big sister. 

I think she loves her!

Ready to go home. 

Proud mama. 

34 Weeks

I've been meaning to write this post for some time now. Although I'm 35 + 4 now, hitting 34 weeks was a huge milestone for me. 34 weeks is the most pregnant I've ever been. On Tuesday, September 3rd, 2013 I delivered my twins girls at exactly 34 weeks. 

As this milestone approached I felt myself getting more and more anxious. The crib still wasn't painted or assembled, the dresser was still in the garage, and all of the wall art was sitting in the "baby's room" on the floor. On top of that, I was planning and crafting for the girls' birthday party. I tried to explain to W how nervous this was all making me, and eventually he got the idea. By my 34 week date we had a crib assembled with bedding, a dresser in the room, and most of the wall art up. I was feeling so much better about things. 

Even though I know most babies don't come that early, I was still super anxious about hitting (and crossing) the 34 week mark. 

Tomorrow I will see my OB to get instructions on my switch from Lovenox to Heparin at 36 weeks. I never made it to that point last pregnancy, and it's a huge step towards (hopefully) having my VBAC. The lovenox was the reason I had to be under general anesthesia for the birth of the girls. I started weekly appointment and will have another ultrasound next week. 

To me, 34 weeks was a huge milestone that needed to be celebrated (despite all of the anxiety it came with). I'm so grateful every day to still be pregnant, even though it's not always the most glamorous thing. It's funny I was worried about having a preemie for so long and now that I'm almost past that point I'm hoping I don't have to worry about going a lot past my due date. It's amazing how your perspective can change so quickly. 

Viability!!!

Last Saturday I hit 24 weeks in my pregnancy. It's so amazing how fast the time has gone, and it's hard to believe how soon baby girl #3 is going to be here.

The newest nursery in our house still looks like a guest room. It's painted blue and has a full sized bed and large desk. I've been searching for a nice crib on Craigslist, but nothing really has come up. W's parents have a dresser we can paint and also use as a changing table. I think I've picked a theme/colors for the room, but sometimes it's hard to tell online. I ordered a crib skirt and am hoping it helps us with the rest of the room. It still hasn't shipped though, so progress isn't exactly happening yet. I know we have all summer, but I also feel like we were so much more ready last time. 

I'm feeling lots of movement and baby girl has even gotten the hiccups a few times. I love feeling those little movements. 

I'm still experiencing nausea and food aversion. Eating can be challenging. We spent last weekend in NJ for a bridal shower and eating was the most difficult part. I don't want just anything, so it was tough. Otherwise, we had a great time with family. It was a nice chance to re-set some of the patterns the girls seemed to be stuck in, like waking up before 6:30 and not eating well. Since getting back they've been napping better, sleeping in later, and inhaling all the food we give them.

I had my first appointment with my new OB yesterday. Unfortunately, the wait times weren't any better and I spent 45 minutes in the waiting room before being called back. Once I got called back I had to answer what felt like a million questions. It took quite a while before I got to see the dr. The dr was great! I learned this practice has a cesarean rate somewhere between 6 and 8% and a VBAC success rate above 80%. All of these things sounded great to me. The dr said my platelets were a bit low with my last round of blood work so they wanted to draw more blood that day and continue to monitor that. I was informed of the risks (and benefits) of a VBAC and signed a consent form. I then learned that this little baby is breech. I know I have a ton of time to get her to flip, but I didn't like hearing that. I feel like had it been my old practice they would have had a "told you so" attitude about it all. They would have been trying to schedule my c section then. Instead, this new dr stressed that we have tons of time to get baby to move and offered me exercises that can help. She also said there are things that can be done around 36 week to help if baby hasn't flipped by then. The chiropractor I see is trained in the Webster technique and is able to get a lot of babies to flip. I texted her and told her we better make this happen!

As I was leaving the office I was tempted to take a picture of their bulletin board. It was full of things that totally appeal to me: my prenantal yoga class fliers, breastfeeding help and support as well as a breastfeeding cafe, doula information, reiki and massage, chiropractic care, etc. It was like a breath of fresh air!

In other news we have hired a doula. She came to the house last week to meet with us and talk and I loved her. I actually talked to her when I was having difficulty with breastfeeding as she is a LLL leader locally. She's actually the one who referred me to the really great IBCLC that identified Lucy's problem and helped me work through it. Jen will come again next week for our first prenatal appointment. I'm really excited about having someone to help and support me through this process.

I've gained a total of 10 pounds now but am at the weight I was when I got pregnant with the girls. It's crazy to compare the pictures from last time to this time. Two babies make a huge difference! My belly is definitely obvious and I feel like people give me looks when I'm out with my toddler twins and big belly. I keep hearing about how I must have my hands full. I have developed diastasis recti of my upper abdominals, but my chiropractor is confident she can help me fix this once the baby gets here. I think all of the lifting of the girls has contributed to that since I didn't have it last time.

I'm feeling lots of movements, and learning about how the baby is positioned helps to try to figure out what I'm feeling. W has been able to feel a few movements, but none are huge yet. I'm craving salad like crazy as well as iced tea. I'm really trying to pair protein with most meals in an attempt to avoid gestational diabetes, but we'll see in 4 weeks when I take my test.

I can't believe we're already at 24 weeks! I'm hoping we can start to make some progress with the nursery so I can feel a little more confident about things. I'm so glad my appointment went so well yesterday, but baby girl better get on the move and start flipping! 

Interviewing Another OB: The Search Continues

On Thursday W and I met with another VBAC friendly OB in the Syracuse area. I was given his name through the ICAN group and was looking forward to meeting with someone else and getting another opinion. I was also excited that this practice offered appointments later in the day so that W could come with me. 

We unfortunately arrived a bit late due to me not being ready when W got home and encountering a bunch of traffic. The nurse was super friendly and nice and told me to stop apologizing for being late. 

She took a urine sample, my weight and blood pressure, and then brought us to a room and told me to undress completely and put a gown on. Being that I was super late for my appointment I didn't argue with her. I knew I was only there to talk with the Dr, so I changed and waited for him. 

When he came in my first impressions were fine. We joked about me wearing the gown and he offered to let me change, but I said whatever. In hindsight I really wish I had changed back into my own clothes. 

The Dr. spent quite a bit of time with us. He asked about my history and why I wanted to talk with him. In the end, I think he got the complete wrong impression of me and my reasons to want to attempt a VBAC. He said I needed to get over the emotional aspects and that lawsuits were so prevalent in NY state that he wouldn't tell me anything different from my current provider. He said, "The only person who really knows whether your VBAC is successful is your lawyer, two years later." He talked negatively about ICAN and told me I need to "stop talking to groups of women and watching movies." He acted like my blood clotting issues were a huge deal and like they'd be a complication in whether I'd be successful or not. I'm pretty sure he thought the reasons I want a VBAC is so that I can say I had a natural birth. That's not the reason. It has nothing to do with my ego. He basically told me to "get over" the negative experience I had last time. 

We left the appointment both feeling disappointed. I think he made a few valid points and got me thinking some, but I would never transfer my care to him. I'm quite sure he didn't want me as his patient either. I guess the feelings were mutual.  

To reiterate, I'm not opposed to a c section if I have to have one for my or my babies safety. I'm just opposed to the idea of an unnecessary c section because I reach an arbitrary date. 

What If I Say No?

I really like my ob's office. They've been great about working with Dr. Braverman, continuing to prescribe necessary medications, referring me out when needed, and getting me in for appointments. I originally picked them with my twin pregnancy in mind. I knew I wanted to deliver at Crouse Hospital where they have a level 3 NICU. I asked multiple people (including my primary doctor) for recommendations. The overwhelming response was this practice. 

The practice has 5 drs in it, 2 of them being men. The youngest and newest Dr in the practice was the one to deliver my girls. Even though she wasn't my favorite, she did a great job and would even track me down in the NICU to check up on me the days after delivery. 

All in all, when I look back I know I want this delivery to be nothing like my last one. Getting into a car accident and being on Lovenox all meant I needed a emergency c section under general anesthesia. I think having the most conservative doctor on call that day also dictated the way things went. 

I'm not going to lie, recovery was rough. I'm sure part of it was that I was in a car accident and was super sore from that, but it was so much worse than I expected. I remember thinking that first night (and beyond to be honest) that I was so grateful someone else was taking care of my babies. 

I'd say it took me two weeks before I felt like I could move in bed without abdominal pain or ride in the car without wincing in pain every time we went over a bump. I also stayed 5 nights in the hospital.

Recently I found out about a group called ICAN. This stands for the International Cesarean Awareness Network and one of their goals it to prevent unnecessary cesareans. As crazy as it is, this international group was started here in Syracuse, NY. 

I've been in contact with one of the leaders as she teaches both pre-natal and mama baby yoga classes that I have attended many times. She attempted a home VBAC (vaginal birth after cesarean) this past fall. She ended up being transferred to the hospital for delivery, but didn't have a c section. She also didn't go into labor until she was 42+ weeks. When I found out I was pregnant I contacted her and we got together with our kiddos for lunch. 

She gave me the name of providers that were known to be VBAC friendly. At the time, I was still really early in my pregnancy and under the care of Dr. Braverman. I wasn't ready to make any changes to my care due to my level of comfort with my current provider. 

A few weeks ago I attended my first ICAN meeting. They showed a documentary called Trial of Labor which really resonated with me. The biggest take home message I got from the movie is that the provider is the biggest factor in VBAC success.  

With each of my appointments I've mentioned it. I've tried to talk to all of the different providers in my office to get their opinion. Basically, what I've been told is that if I make it to 41 weeks they will want to schedule a c section. Induction options are limited due to the risk of a uterine rupture, and to be honest, I don't want any unnecessary interventions. 

I don't think I realized how traumatic the birth of my girls really was to me until I watched that documentary. They didn't allow my husband in the room so neither of us heard them cry for the first time or saw them enter the world. The anesthesiologist held his hands on my throat as I went under to "keep my airway open", and I woke up disoriented and in a lot of pain. I wasn't able to see my girls for hours after they were born and wasn't able to even hold Lucy until the following day. I'm not sure I'd remember those first encounters if it weren't for the pictures. 

I know this time around, if I can control it at all, I don't want my birth experience to be like that. 

So, I started calling talking to more people and calling other providers last week. I found another practice that was highly recommended that delivers at Crouse Hospital but is also extremely VBAC friendly. They have an 80% VBAC success rate. I've even heard they try to avoid using the word cesarean. So, I sucked it up and called on Friday. I was so bummed and discouraged when they told me they weren't accepting any patients delivering between May and October. 

When I heard that I started thinking. I remembered that one of the Drs in that practice is also a member of our local Multiple Mom's Mingle Group. So, on a whim I wrote her a private message on Facebook. She said she likely wouldn't be able to help to get me in, but we discussed my impressions of my practice and then some alternatives. A few days later I got a new message from her stating that she spoke with her nurse manager. She gave me her name and told me to call her on Tuesday. I haven't made that call yet but I hopeful I may actually be able to get in there. 

So, yesterday I had another appointment with my OB to get a B6 injection. I was very upfront with the Dr I saw and told him I was debating switching practices. I asked him what would happen if I reached 41 weeks and so no to a scheduled c section. He then told me they couldn't make me do anything I didn't want. He said they would likely have to monitor me more closely with non-stress tests and inform me of the risks and document that in my chart. In those 5 minutes he used the words "stillborn" and "expired". They couldn't refuse to treat me even if I refused their recommendations. 

I'm not sure how I feel about it all. I joked to W that I'm going to feel really dumb for making such a big deal out of all of this if I go into labor on my own before that 41 week mark. But, ultimately, I know what I want for myself and this baby and I know I don't want surgery if I don't have to have it. The thought of taking care of an infant, establishing breastfeeding, and also caring for my toddler twins while recovery from surgery is daunting to say the least. Don't get me wrong, I'm not opposed to a cesarean section is it's necessary. I just don't want to sign up one. 

I know another step I need to take is finding a doula. I've gotten a few names and plan to research that soon as well. 

In addition, I have an appointment scheduled with another VBAC friendly provider in Syracuse (according to ICAN) for this Thursday. I hope to speak with a few different doctors and pick the one I feel I am most comfortable with and that will best support my personal decisions. Why is this so difficult?