Upset with OB (kinda long).Need advice

[cml112]

So I call my OB on Tuesday asking about if my progesterone level will be tested prior to ending cold turkey. The nurse told me it was protocol that I only have PIO until 12 weeks. I have enough PIO to get me to 10w 3d. So she has to speak with the doctor (whom I have never gotten to meet or speak with).
So another nurse calls me back yesterday and her and I go through the same thing, except she is more adamant that I don't need it or to be tested. She has no idea what my levels are, I've had bleeding on week 5 and 8 which could possibly be due to low progesterone.
I fought with her on this for about 5 minutes, with her saying I need to go back to the RE and get her to call in a refill. I haven't seem the RE since week 5!!! I was D/Cd to the OB and who had said the OB would take over from there. The OB nurse felt that would be stepping on the RE's toes to test my progesterone....WHAT?! Then she said she will go talk to the doctor and call me right back. She never called me back.

Why am I having to advocate this much for myself? If they can't even order a simple blood test, can I really trust they are going to have my best interest in mind in the future? What should I do? I only have enough PIO to get me to Wednesday?

[luvboston]

First of all why did your re release you so early? Second I would insist on the doctor calling you and if that doesn't happen find a new practice. I would call the re and have them do the test and give you a refill because at this point it looks like it will be two weeks before you get an answer.

[IFinTN]

Can you see if they will at least let you take suppositories (pg pill up vag) if they don't want to do more PIO? I was able to get off the PIO by 10 weeks and then weaned off supps to be off by the end of week 13.

If it makes you feel better, the placenta takes over production between weeks 10-12 and it won't show up in your bloodwork, so testing may not really help right now and may just make you worry more (that's what happened to me!)

[katemonster]

That's annoying, sorry you have to deal with it. I was on suppositories, not pio, but did not have my levels checked after about week 6. My RE didn't even check progesterone at my second ultrasound. I just stopped progesterone and estrogen cold turkey at whatever week my RE said - 10 maybe?

[lilyharper]

Is it possible your RE would be willing to order the bw? Graduated or not, they may still do that. We graduated today, but I'm having bw done this weekend to figure out tapering off meds, and may have to run it again depending on what the numbers say.

[luvboston]

Also how did they deal with the bleeding? Did they test your progesterone at that point to make sure you were on enough meds?

[meatandbandp]

Your RE released you very early. My RE continued to monitor my progesterone even after I was released and they dealt with my tapering off of pio at 12 weeks even though I was released at 8.

[ginnyjones82]

I would call your RE. Then maybe shop around for an OBs office that takes IF histories more seriously.

[hbanana18]

I was on suppositories 1x/day and my OB had me stop at 10w. I don't know protocol for PIO though, plus with your history of some bleeding, I understand your frustration. I think the bigger issue is the attitude you're getting from the nurses there and lack of response. You've basically hired them and deserve more than you are getting. I would try to speak directly to OB and if you're still having trouble, I would consider looking into other OBs.

[jessimi06]

The RE released you pretty early, and if you're having problems at the OB's office I would call the RE office to get a refill. I'm sure they'd at least do that for you. If it makes you feel better, I didn't have blood work done before I stopped PIO (it's not commonly done as the placenta takes over between 10-12 weeks), but I would think they'd at least order it to give you peace of mind.

[cml112]

I thought 5 weeks was early, but my RE was comfortable since my BETAs were so high. It seems like OBs just aren't as familiar with IVF as I would like. Sometimes I've felt like I'm educating them.

Ketchup, I kinda worked my way backwards so to speak. I knew the hospital I wanted due to the NICU/birth center and so I scouted docs that are affiliated with that hospital. I got a recommendation for this practice from 3 people, but I've never met the doc.
No, the OB did not check my Progesterone even after the spotting. They did an U/S only.

I feel like it's a huge red flag that I have to fight with them so much over something that could be solved so easily. I'm stressing myself out over this and it might not even be a cause for concern if my levels are good. But who knows? What if (later on) I hadn't felt the babies move in a few days and felt there was something wrong, am I going to have to fight for an U/S? My SIL went to the doc for this and they found out the placenta was not functioning and did a CS that same day. I have a new little nephew because of her mommy instincts. I feel like this office would brush me aside.

So they have already lost my trust. So I think I'm going to switch to the other practice I was considering and call my RE.

[Deleted]

Dude, wtf? I second everything luv said.

[IFinTN]

Definitely switch. My nurse is very responsive and my OB is very sensitive to my IF/IVF history. Don't accept less!!

[bluefairy5]

Glad to hear you're leaning heavily toward switching. Is it possible your RE has a recommendation or two? I already have a negative view of most OBs after our early IF diagnostics experiences, but a practice where they apparently won't even let you talk to the physician just sounds kooky.

[cml112]

Feb 28, 2015 11:07:25 GMT -5 bluefairy5 said:

Glad to hear you're leaning heavily toward switching. Is it possible your RE has a recommendation or two? I already have a negative view of most OBs after our early IF diagnostics experiences, but a practice where they apparently won't even let you talk to the physician just sounds kooky.

When I started my OB search I asked my RE for recommendations, but she wasn't overly familiar with NH since they are based in MA (I did my monitoring at a satellite office near my home).

[sunshinedaisies]

I had a similar experience with my first OB. My RE stops monitoring after the first u/s. RE also never checks progesterone levels (presumably because of the high dose). I was supposed to stop PIO cold turkey at 10w3d and I went through 10w5d. I then quite 2mL cold turkey and started having bright red bleeding right after. I freaked out and my OB didn't want to let me come in to check all was okay (they told me to wait 2 weeks for my NT scan). I had to argue to get in to hear the HB on a doppler. I then had to argue with them to get progesterone pills to take to wean me off until my next appointment.

Right after that, I realized if I had to advocate to make sure everything was okay (when I've heard countless stories of others being monitored, reassured by their OBs, etc), I didn't want them in charge of my care. I called up a new practice the next day that also delivers at my hospital and have never looked back. My new place is amazing.

Point: you are in charge and the paying customer. You are the one that should feel that your needs are being met. If not, don't look back. Do what's right for you and screw them.

[hearthands]

The RNs were really insensitive & frankly sound like they lack the critical thinking skills to say: "I hear how concerned you are. I will try to get an answer ASAP."

In most offices the staff (RNs, Medical Assistants, etc.) work as the gatekeeper for the OB/Midwife. Good staff get questions to the provider immediately. Bad staff act like passive aggressive bizatches.

Trust your instincts, there is very likely a better office out there to take care of you.

[cml112]

XP: UPDATE on my progesterone saga. I called my RE today and she actually called the OB. 20 minutes later I get a phone call from the OB to have me go to the lab for bloodwork. Kinda feel like I went to mom to tattle, but when it comes to my babies I don't really care what they think of me! Don't mess with my mama bear side!!! I'm still switching, made arrangements with the new OB.

[bluefairy5]

Glad you're still switching, but in the meantime, fist bump to your RE! I'm so glad she advocated for you!

[IFinTN]

RAWR!!

[dharmachick]

I'm so glad that your RE heard your concerns and is addressing this.