Re: Post-cerclage bed rest? (pregnancy mentioned)

[Guest guest]

> My OB is insanely busy and didn't return my phone calls...>

,

This is one very big red flag in my opinion. You must have a Dr. who

provides the special attention that you will need during your

pregnancy. You might want a different Dr.

Star

[Guest guest]

,

Congratulations on your pregnancy! I hope you have a long, uneventful

pregnancy!

I have read that the ideal time to place a preventive cerclage is between 12 and

14 weeks. I have not had a 2nd trimester loss, but have had a lot of difficulty

getting pregnant and knew that I was at risk for IC (many women with MAs are).

So, I started being monitored at 10 weeks and when significant shortening was

noted at 13 weeks my doctors (Ob and Peri) recommended having a cerclage placed

immediately.

That's a brief history, now to answer your questions... After the cerclage was

placed I was monitored at least every other week by transvag u/s. Initially, I

was on restricted activity (I could work, but was told to minimize walking,

standing, and no travel). After about 6 weeks of no change in my cervix, my

doctors allowed me to resume normal activity as long as my cervix remained

stable. I started walking more and took three airline trips during this time.

I continued to be checked every other week by transvag u/s. At about 27 weeks I

started having signs of PTL and my cervix started shortening again. At this

point I was put on modified bedrest. I was to remain in bed, but could be

sitting for several hours a day, could get up to use the restroom and to eat

meals. I continued at this level of activity until 36 weeks of pregnancy. On

rare occassion when I would increase my activity level I almost always ended up

in the hospital due to PTL. I resumed normal activity after 36 weeks until the

day I delivered at 36 weeks 5 days.

I did see one Peri who said that I would be on bedrest for two weeks post

cerclage and then could resume normal activity until delivery. I decided to go

with the more conservative experienced Peri who maintained that placement of a

cerclage was not license to throw caution to the wind but rather should be done

in conjuction with activity modification and close monitoring for cervical

changes.

Now for the unsolicited advice that you are free to ignore... I tend to agree

with Star that you might want to consider a different Ob if this one is not

responding to you. You are a high-risk pregnancy and with that comes certain

responsibility on the doctor's part. I visited 6 doctors (after the 10th week

of pregnancy) before settling on one. It was not easy visiting all of these

doctors while working a full-time plus job but I feel it was worth it. My Ob is

awesome in that she always returns my calls and gets me in the same day if

needed. My RE referred me to her and was emphatic that I needed to be with a

doctor that would give me the individual attention that my situation mandated.

She was right and I credit my Ob for making sure that I stayed pregnant for as

long as I did, had a relatively smooth delivery, and a perfect baby!

I hope that everything goes smoothly for you during this pregnancy! Take good

care of yourself and baby. If you have any additional questions about a cerclage

I'll try to help answer them.

Mikell, 34

t-shape

1 dd 12/05

1 mc 2/04

[Guest guest]

Star,

I have been going through the same quandary (sp?) about that. The OB

herself is wonderful---she really did what it took to get my daughter

here and did such a great cerclage that they couldn't get it out until

during my c-section! She would never leave an appointment with me

until all my questions were answered and we were " on the same page "

regarding my treatment.

Her practice, however, is a mess from an administrative standpoint. 1-

2 hour waits for weekly cervix check appointments were quite common.

You can never speak to anyone there, it's all phone systems and voice

mail. Her staff (with minimal to no medical training) often act

as " gatekeepers " to patient care, deciding what tests to order and if

your situation warrents getting the attention of the MD's themselves.

I'm sure the OB herself never responded to my call, that it was just a

staff member screening the messages.

There is also a horribly, twisted, mean OB at the practice who I pray I

never see again. This terrible woman ALMOST caused me not to be in my

Perinatologist's office the day my cervix was opening. The Peri had

decided he wanted to see my cervix weekly by ultrasound, and at my next

OB appointment I met with the evil doctor and told her these were his

instructions. She flipped out--- " he's trying to usurp our care! we're

your doctors, not him...I'll put a stop to this! " She called him and

read him the riot act, insisting that these are not " his calls " to

make. I ALMOST listened to her and didn't go to that next appointment

(which she thought she had canceled for me). I decided to keep the

appointment because I wanted to talk to him more about my care---after

all, if my insurance was willing to pay for it and I was willing to

invest the time, why would any doctor say there was " too much " care?

The rest is history. At that appointment, my cervix was diagnosed as

incompetent and it was opening from the pressure of the baby's head. I

was sewn up within a few hours. This was one of the many circustances

that could have easily gone a different way and my daughter wouldn't be

with us today. Again, I'm sorry things didn't turn out better for you.

Long story short (ok, this wasn't so short and I realize the fear and

bitterness is still fresh b/c I'm unloading so much here), I love the

OB herself but I am considering finding somewhere else because I can't

deal with the evil partner at her practice (there are a lot of other

things that doctor did that make me hate her) and because I don't know

if my care will suffer as a result of the organizational disfunction at

her practice. But, I live in suburban Philadelphia, and the health

care crisis is excellerated here (the malpractice attorneys are living

in palaces while the OB's are switching to Gyn-only practices). I

don't know if I can do any better. Back when I was pregnant and had

the " run-in " with Dr. Evil, I was seeking other OB's around here and I

posted to this group. The few recommendations I received were for

doctors downtown. With weekly + visits and repeat PTL visits to L&D, I

wonder if my care would suffer with the extra travel time and logistics

involved in that.

If only we had a crystal ball!!!

Thanks for prompting my next post, however. I'll ask the group again

if they have any recommendations for an OB and/or if I could possibly

get away with being cared for exclusively by a perinatologist (or a

Peri-midwife combination).

Thanks for your opinion---you are 100% right to see the " red flag " in

my message.

>

> > My OB is insanely busy and didn't return my phone calls...>

>

> ,

> This is one very big red flag in my opinion. You must have a Dr. who

> provides the special attention that you will need during your

> pregnancy. You might want a different Dr.

>

> Star

>

[Guest guest]

,

Your OB sounds EXECTLY like mine. I really like her a lot but she

has the same administrative chaos. My stomache turned a bit when my

family started talking about a law suit. I'm not sure I want that

but I do know that I am going to find a new OB for our next attempt.

I'm going to ask my RE to recommend someone who can spend time

focusing on my needs. Hopefully this person will also have

experience with MA's. I also was using a Dr. who was close to home

because I thought it would be better to have someone nearby. Well,

that didn't really become a factor. I think it would be better to

drive a distance & get the best possible care.

> Star,

>

> I have been going through the same quandary (sp?) about that. The

OB

> herself is wonderful---she really did what it took to get my

daughter

> here and did such a great cerclage that they couldn't get it out

until

> during my c-section! She would never leave an appointment with me

> until all my questions were answered and we were " on the same page "

> regarding my treatment.

>

> Her practice, however, is a mess from an administrative

standpoint. 1-

> 2 hour waits for weekly cervix check appointments were quite

common.

> You can never speak to anyone there, it's all phone systems and

voice

> mail.

[Guest guest]

,

I am so glad I am not alone, I went through 4 OB's until I found the one I

have now. One of the OB's I really liked but when I wanted a simple question

answered I had to call 4 time before I finally gave up (I never did get that

phone call back). Is it me, or is it harder and harder to find a good

doctor these days. When I was diagnosed with an abnormal uterus, my OB sent

me to a specialist that freaked me out. In one visit he told me I had a

possible B/U, an entopic as well as a pseudo pregnancy. But he couldn't

answer my question on why and exactly what it was. The next day I went to a

" fancy " doctor and he told me that I did not have an entopic, I might have a

b/u or s/u and regarding the pregnancy he just wasn't sure yet. the problem

with him was he didn't have good bedside manner, he just didn't have enough

time to spend with me. And during a scary time like this I need that extra

special attention. I finally found a fabulous doctor in Tarzana, CA. He sits

with us for however long it takes, answers all our questions and is nice! I

wish you good luck with your search with a doctor too!

Nickey