Doppler Ultrasound

One of the things Dr. B recommends in the first trimester is weekly ultrasounds. This includes looking at doppler blood flow of the uterine artery. When I saw Dr. B at 7 weeks he did my ultrasound including the doppler measurements. I asked about his findings and he said he noted reduced blood flow to my uterus, but great blood flow between my uterus and the baby. He looked at my chart and said he wasn't going to change my current dosage of Lovenox since I'm already taking it twice a day. Last time I remember having to increase my Lovenox dosage and also using Viagra vaginally to help increase blood flow. 

Getting this done at Dr. B's office is fine and easy but getting it done outside has been a bit of a headache. At 8 weeks I went to my old fertility clinic for my ultrasound. The nurse practitioner came in and noted it on the ultrasound. She said, "We don't normally do that." When I asked why she said something about increased risk and exposure to the baby. She said she could get my old RE and see if he was able to do it, but I told her to just do the ultrasound. I didn't want to make a big deal out of it. When she was finished she said, "The hospital may be better able to accommodate you."  

At 8 1/2 weeks I had my first ob appointment that included an ultrasound. I asked the ultrasound technician if she could do the doppler. She also said it wasn't something that's normally done this early in a pregnancy. 

When I met with one of the Drs in my ob practice I told him Dr. B was requesting this information in addition to a weekly ultrasound. He was great about working with Dr. B and his suggestions and said he was willing to follow any of them. He asked his nurse about the ultrasound, she asked the ultrasound technician, and they all agreed I'd have to go to the hospital to get it done. With my pregnancy with my twins I had a few ultrasounds at the hospital so it didn't seem like a big deal. The nurse told me I would hear from her and I left. 

The following day she called and told me she needed to call Dr. B's office to get clarification for what she was requesting. The day after that she called to tell me I had an appointment scheduled for the next week at the hospital. 

Yesterday I had that appointment. Going to the hospital made it so much more complicated. I had to register (which included a ridiculous amount of paperwork) and my elevator confusion, sitting in some weird room without any kind of receptionist for at least 10 minutes, and then going to a room with two technicians. They were both somewhat confused by the script. They also commented that it was very early on to do doppler readings. I tried to explain to them to the best of my knowledge what Dr. B measured and why. Then they started. It felt like it took them forever. They did first check the baby so at least I saw that quick before they took their twenty plus minutes to do the doppler readings. All I could think was about those comments about it being done so early and the extra exposure. The technicians were so fascinated by the doppler as it is so early in my pregnancy and kept commenting on how "pretty" it was.  I think I made their days as it was definitely something out of the ordinary for them. 

From there I was sent to my doctors office. I called and asked the nurses if it was totally necessary and she made me feel like it was. The wait times are super long at my office and I really didn't feel like sitting there to find nothing out. I knew it was pretty much pointless. Another hour later I left the office. The dr basically agreed it was pointless since he didn't really know what the doppler measurements meant but did say everything was looking great and the baby was measuring right on target. 

Next week I'm supposed to go back to Dr. B's office to have an ultrasound. The week after that I'm supposed to return to the hospital. I'm honestly debating canceling it because of what a pain it was. I guess I'll just wait and see how I feel when the time comes but maybe asking Dr. B about all of the "it's so early for doppler" comments to help ease my mind may help too. It's quite apparent that the way Dr. B thinks and operates is very different from most doctors. 

First OB Appointment

Yesterday afternoon was our first OB appointment. They called me back and had my hubby wait in the exam room while a nurse took my blood pressure, pulse, weight, and a list of my medications. She was definitely frazzled with all of my medications, but what can I do? I'm sure it's not everyday that the list includes so many. My blood pressure was, amazingly, really good. My pulse was a bit elevated.

I then waited with W in the exam room. The same nurse came in, frazzled again, and started to talk about labs and cultures and my insurance. She asked me to look something up about my insurance so I started as we waited. Another nurse then came in and explained that we didn't need to worry about anything and that they had it figured out. She asked whether it was our first pregnancy and we told her "sort of." We told her we had 3 previous losses and she was super sympathetic and understanding. She reassured us that if we had any questions or concerns at any time that we should feel free to call.

When Dr. Hi.ll came in she had her laptop and asked about our complete history. We gave her the run-down and joked about how she was writing a novel. It was hard to re-hash it all and I was practically in tears by the time I got to the end of it. It's a long story that contains a lot more downs than ups. It's not too often that I go through the entire history with someone, so it was hard. 

She was so happy and excited for us that things finally worked out. We told her about how we are still working with Dr. Br.averman, and she was more than happy to coordinate care with him. She seemed happy to take a back seat in the decision making until it was her turn. We told her we will meet with him again at 12 weeks and he will make a plan for the rest of the pregnancy. She said with those recommendations we can move forward. She said she could probably learn a thing or two from reading his notes in the files that were sent over. I was so pleased with how open she was to working with him and following his recommendations. It was such a breath of fresh air from working with my local fertility clinic.

She then explained that she would do a pap smear, pelvic exam, and some cultures so left the room while I undressed and got ready. It was weird to have W in the room while a pap smear was done, but we joked about things so he was fine with it. He's been in the room for at lot at this point so he's not easily phased. The doctor warned me that I was going to have quite a bit of bleeding from the pap. Her gloves in the garbage were covered in blood, as was the table when I got up. The nurse gave me a pad and the doctor repeatedly reassured me that the bleeding was from my cervix, not my uterus.

I gave a urine sample and then we headed down to the ultrasound room. I was so happy we were getting an ultrasound, but disappointed when they referred to the machine as a "dinosaur". The machine did not provide crisp images of our little ones, but we saw them and it was great. They measured on target but the machine did not allow us to hear their heartbeats. Dr. H promised that for our next appointment we would get an ultrasound with the better machine.

She asked us about genetic testing and we said we wanted to do the NT scan (mainly for an extra ultrasound). I told her that Dr. B wanted me to be seen weekly and she gladly agreed, saying we had been through so much and was happy to do that. I asked some other questions and she was honest and straightforward with her answers.

By the time we left the office we had been there almost an hour and a half. We were long past the time that the office normally closes, but I was so happy the doctor spent so much time with us and never made us feel rushed. The other office staff did not look as happy as W and I were. We made an appointment for next week for an ultrasound and to meet with the doctor again.

Overall, it was a fantastic appointment. We felt like the doctor was compassionate and bright, as well as open to working with Dr. B, which is very important to us.

In other news, I got my doppler this week and have used it quite a bit. The first 4 or so times I tried it the first day I didn't have any success. Finally, on my 5th attempt I found a heartbeat. It was amazing! The next morning I tried it again and am pretty sure I found 2 different heartbeats. They were in different spots, but it is impossible to know for sure. Since then, I can easily find the first one within seconds of trying. The other one is more difficult, but I can find it with some persistence. The doppler has been amazing and I love listening to the sound of my little babies. It was such a great purchase!