Grr!

[lillibet]

I've never really liked my OB/GYN. She has a very distant manner and never seems to quite remember having any idea who I am, even with my chart in front of her. We've never established any kind of rapport and she's annoyed me a couple of times in the past with unsatisfying answers to my questions. But I'm sort of lazy about gynecologists, because I've never had one I really liked and usualy just get the NP at my PCP to do my annual smear test, etc. Seeing the OB once a month wasn't a big deal--no, I don't like her, but I don't feel a real need to do so. Now that I'm seeing her every two weeks (and switching to once a week in December) it's becoming more of an issue and today's appointment left me really unhappy.

A month ago, I had a one-hour glucose test (you eat normally, then drink 10 oz. of flat orange soda stuff, and go into the office to be tested exactly an hour later). That number came back "a little high" so three weeks ago they had me do the three hour fasting-test (you go in first thing in the morning, having eaten nothing for at least 8 hours, they test your blood "empty" then have you drink another bottle of the glucose cola and sit around while they test you again after one, two, and three hours). My fasting number was fine, my one-hour number high, my two- and three-hour numbers fine. The rule is that they don't consider you to have gestational diabetes unless two or more of the numbers are high, but the nurse called to say that the doctor wanted me to see a nutritionist anyway. So I did, promptly, which was something of an achievement for me, since I sort of hate that kind of thing. ("Margaret declines to be lectured on the food or beverage she sees fit to take.") That went well and I rather liked the nutritionist. She was a little puzzled as to why the OB had sent me in, since my results weren't over the threshold, but said perhaps the doctor just wanted me to have the information the nutritionist could give me in case later tests did show a developing problem. Oh, and yeah, probably not a bad idea to watch the carbs. Since I don't normally eat a very high-carb diet, this didn't seem like a real issue, but I have been paying a little more attention to it than I usually do.

Two weeks ago I had another appointment with my OB. We discussed the results from the three-hour test, I said that I had seen the nutritionist, we went over what I had learned from that consultation, and she nodded and said nothing more about it. At that appointment I actually found the OB more personable than ever before and came away thinking that perhaps I've finally adjusted to her personal style and found a way to relate to her more smoothly.

Today I went back for another appointment and she went back to the results and asked "what are you doing about this?" I was confused and said that I had seen the nutritionist and was making an effort to follow her recommendations. She asked if I were testing my glucose levels regularly and I said no, that no one had suggested I do so. She frowned and asked when I had scheduled a follow-up test and I said that I hadn't, that no one had suggested I do so. She then told me to set up an appointment, talked about both a two-hour fasting test and a post-prandial test, not making it clear which I was to have or what the goal of either would be or how they would differ. By that point I was, frankly, so confused and trying to sort out in my own head what I had heard that I failed to question her more closely. She followed me out to the receptionist's desk and when I flailed a bit about which test I was supposed to have, said to the receptionist "the two-hour fasting test" and walked back into the back room of the office. So I set up that appointment for next week and came home. Jason had been with me throughout this and was as confused as I was and mentioned that while he hasn't been able to understand my dislike for her before, he really saw it today.

I tried to call the office to see if the OB has email (I don't think so, she's never offered it) only to find that they stop answering their phones at 4pm. I didn't want to leave an emergency message with the paging service, and figure I will call back tomorrow and see if I can get some more answers. In the meantime, I've sent email to my beloved PCP asking for his advice about switching OB's this late in the game (I've only got ten weeks to go) and asking for recommendations of other doctors. We're supposed to go to a meet-and-greet with all the OBs at hospital next week (before my scheduled follow-up test) and perhaps that will give me a chance to find one who's more personable. [UPDATE: I've just gotten a reply from my PCP saying that he'd recommend simply switching within the same practice. I'm not thrilled with that answer, as I've seen one of the other doctors once and while she was better than my current OB, I wasn't blown away by her, either. Ah well, I think I need to sit with this and see if I can force some better communication in some direction.]

I don't mind doing the follow-up test, although spending another morning sitting around the doctor's office is not my idea of a good time, but I really want to understand the thinking behind it. Mostly, I'm just frustrated that she didn't mention any of this at my last appointment (since when there is no new information and nothing has changed) and that she couldn't be bothered to explain things more clearly and behaved as if I were failing to do what I'm told, when if there's a failure it was hers. Grr!

Comments

[muffyjo]

What a royal pain in the patookus! I'm so sorry you have to go through this. BLECH!

[hammercock.livejournal.com]

Wow, that sounds irritating. WRT the glucose levels, do you think that she might be making assumptions based upon some prejudice about weight? As if that were the sole indicator...my cousin L, who I just visited this weekend, probably weighed about 130 lbs pre-pregnancy and has developed gestational diabetes, while I've known heavier women who didn't develop it at all. Feh. And, on top of all that, I hate it anytime someone behaves pissily toward me because I somehow failed to be sufficiently psychic. Sheesh.

[bridgetminerva.livejournal.com]

I passed my Gluc test with flying colors. My numbers where textbook results for Very healthy. I was 340lbs then. My next gluc test is 27th.

[kerri9494.livejournal.com]

Switching within the same practice means it's not unlikely you'll wind up with her as your delivery OB -- something I'm guessing you want to avoid. No, ten weeks isn't too late in the game to switch, especially if you have a recommendation from someone. The birth process is emotional enough...the last thing you want is a distant, weirdo doc inside you up to her elbows. As it were. :-)

And FWIW, I did the 3-hour test (I think I mentioned that), and while my one hour number was high (duh), my other two were fine, and nothing more was said about it. I wonder if she read a note on her chart and misinterpreted your history? Or something? I don't know. But docs like that PISS ME OFF.

Good luck!

[entirelysonja.livejournal.com]

Though I will say, my least favorite OB at the practice where I go (who is thankfully no longer there) wound up delivering my last baby, and while I disliked her at the office, I thought she was perfectly fine during labor and delivery. So you never know.

At my OB/GYN office, they actually don't want you to see just one doctor during pregnancy -- since they use a rotation schedule at the hospital, any one of them is pretty equally likely to be at the birth, so they require you to schedule appointments with all of the doctors during the pregnancy.

Anyway, if I were in your shoes, I'd seriously consider switching even at this late date -- while I can deal with not clicking with one doctor out of five at my current practice, I wouldn't care to deal with it if I had to see the doctor I wasn't comfortable with every time.

[minkrose]

That sounds terribly frustrating! Reasons like that were exactly why I switched PCPs (my old one put me on thyroid meds for two years to help lower my cholesterol - except that my thyroid was fine and there was no reason to believe the meds helped my cholesterol at all).

Anyway, this may not be useful because I've only had her as a GYN though she's also an OB: I love Dr. Nicole Boudreau. She's at 1180 Beacon St Suit 2C, Brookline. 617 232 0440.
She always calls me back and takes the time to have conversations in person and on the phone upwards of 10 minutes long. I enjoy her company and I trust her judgment completely. Very smart lady. Also, her father was my mom's OB/GYN for my birth.
Even if you can't change Dr's in the next few months, perhaps you can always change later on? Good luck!

[minkrose]

er, minus the "always" at the end. rewrote the sentence and didn't edit it properly. whee!

[rmd.livejournal.com]

oh, how fucking annoying.

i hate dealing with that kind of situation. GAH.

[ceo]

Wow, that sounds profoundly annoying. I'd be looking to jump ship at this point too.

[orbitalmechanic.livejournal.com]

Isn't the point of sticking to your OB that she'll keep track of how you are and what the history of the pregnancy is? If you can't tell whether she even knows what your test results are (or mean) I don't see much reason to stay. Sheesh.

[pekmez.livejournal.com]

How frustrating.

I'd probably be looking to switch, in your shoes. The reason not for switching would be that this practice is supposed to already know you and the history of your pregnancy thus far - and it doesn't sound much like your OB manages to do that, changing her mind from visit to visit on what to do with the results of your glucose test.

Although this wasn't for related reasons, but for developing pregnancy complications, I found myself seeing a new OB from 26 weeks till 34 weeks (when I was, happily, able to switch back to the midwive practice where I started, having not given birth in the window where it would have been Much Less Good and beyond their expertise) and the biggest hassle was getting the pile of records from one place transferred to the other - if you can own that and be persistent till the papers show up, and find a good place to switch to, I don't think switching slightly later in the pregnancy is a big deal.

(I also had a borderline result on the simple glucose test, and one high reading of 3 in the 3 hour window, and nobody said "boo" about it after that, FWIW.)

[starphire.livejournal.com]

Ugh, sorry to hear about your tribulations at the doctor's office.
Ditto what the others said about probably getting someone else for the delivery, too. When K was born, we lucked out and got the best one, whom we had met at the "meet the practitioners" session and immediately liked.

WTF? ( my opinion )

[bridgetminerva.livejournal.com]

You are being too nice. You should leave a message to talk to your ob.She may not even be aware she is causing you angst. And she needs to be. You are paying her to care for you. This is not at her whimp. It is at your's.
My ob is available to me 24-7 or her CNM is. If I have a concern or even an emotional issue that I think is pregnancy related my ob and I talk about it. At first I felt like I was putting her out during my first pregnancy. But she told me her job was to be my doctor and my advocate during this natural but frightening time.

You need to be coddled not scolded at this time. Please tell her how you feel.

Re: WTF? ( my opinion )

[schmoomom.livejournal.com]

I fully agree with bridgetminerva...this woman is going to have a big say in your next few weeks, and if you're not on the same page with her, she needs to know why and how to get on the same page. Your comfort is the most important thing, not her attitude.

[candle-light.livejournal.com]

I'm sorry your OB is being hard to deal with. 10 weeks to go is certainly enough time to switch OBs if you get on with it promptly. Why would you want someone you can't communicate with and doesn't seem to remember what's going on with you to be helping you when you need it most? A tip I learned from my midwife for the glucose tolerance test is to walk around between blood draws. It helps your body process the sugar. I failed both my initial one hour tests and passed both my three hour tests with flying colors.

[sichling.livejournal.com]

Having an OB who you can trust and interact with well is incredibly important. She or he is the one who will be deciding, basically, if you need a C-section, if and how to induce labor (so you should agree on what you want), and so on.

I would recommend Dr. Fechheimer near Alewife on Concord Ave, I believe. She was excellent through my 3 miscarriages.

[lillibet.livejournal.com]

Amusingly, that's who we're talking about. She came very highly recommended by someone else, as well as being my PCP's first choice. My mileage is varying :)

[sichling.livejournal.com]

hmm - that is amusing. I would try talking to her about your concerns. I really liked her. She wasn't overly emotional, had good advice, and was willing and offerred to start investigating early. She also recommended the doctor who suggested the treatment that I tried while pregnant that successfully resulted in a baby :-) She also recommended that I should get an ovarian cyst out - and suggested that I use Dr. Penzias (at Boston IVF) for that, since he did lots of that type of surgery to harvest eggs.

I would strongly recommend talking to her. I had concerns about differences of philosophy with my OB - and talking solved the problem completely. She was great when I actually delivered and tried everything safe to avoid my needing to have the C-section.