13 weeks and meeting the doctor tomorrow for early screenings (standard) and to establish myself as a patient. I see the regular OB every 4 weeks, as well as my endocrinologist and the nutritionist. How will this be different?
What questions should I talk to the doctor about before/during/after the ultrasound, besides "How's the baby doing in there???"
My pre-conception appt with a high risk doctor was horrible. He was so mean, treated me like a dumb, unhealthy piece of trash - when I was sitting there with my husband, taking off half a day of work to meet with him, discuss our concerns and get as much info as possible! I'm a marathon runner with a low A1C for crying out loud. The doctor's advice was "Do what it takes to keep your A1C low - it's easy....don't put diet coke in your kid's bottle...don't take crack." And for this he was paid $450 by my insurance.
So I'm a little distrustful...And going to a new doctor. So many appointments, and not sure how they all fit together!?!
It's interesting how every hospital/practice does things so differently. My diabetes was managed throughout my pregnancy by my high-risk OB. I never saw a regular OB, my diabetes nurse practitioner, or a nutritionist. In retrospect perhaps this wasn't the best arrangement--but that's how it was done.
In general, you will of course talk about how the baby looks on the ultrasound. You will also probably talk about how your diabetes may affect your baby and the plan for all of the ultrasounds, non-stress tests, etc that will happen throughout the rest of your pregnancy. If you're thinking this far in advance, you may want to talk about what will happen when the baby is born (i.e. what are the doctor/hospital's criteria for performing a c-section, what will happen if the baby is hypoglycemic at birth, what are the criteria for sending the baby to the NICU, etc).
Wow - you sound a lot more prepared than I am at 15 weeks! At my first meeting with the maternal-fetal specialist, they had a lot of Q's for me moreso than the other way around. One thing I've noticed is that the high-risk ob/gyn group I'm seeing has varying degrees of familiarity with insulin pumps and intensive management. The primary person I've met with and talked to makes recommendations like "take 2 more units at dinner." This is not very helpful as a suggestion to me, a better recommendation would be to lower my ratio at dinner or reduce my correction factor but I'm not sure by how much. I would ask whether the person who you're meeting with has much practice or training fine-tuning insulin dosages and, if they don't, if they can coordinate with your endo or allow you to work through your endo for tweaking as needed. Hope this helps! I'm in Cleveland, btw, so if you want to talk more f2f I'd totally be up for that :)
A good question for the doc is how many appointments am I going to have? I wish I took notes on this one as every few weeks they get more frequent, with 2x a week during the last few weeks (maybe after week 30). I also asked him a ton of questions about what they saw on the ultrasound and how my baby is measuring up.
My MFM is great, but at my first appointment I almost started to cry when he just kept going on and on and on about all of the horrible things that can go wrong in a pregnancy with a woman with diabetes. So far, my whole pregnancy team of doctors have been very pleased with my progress and management thus far. Being in control makes everyone calm down a bit, but I think they prepare you for the worst case scenario.
I would also ask him/her if the office has access to any CDE's (diabetes educators) and if your endo or the MFM office will be following your BG readings more closely. At my last visit, the MFM took a glance at the spreadsheets and logs that I brought and just asked who my endo was and if she was following me throughout the pregnancy. Once I told him that I was seeing her every 3-4 weeks, he was just like ok and didn't talk much about my BG.
Good luck! I am 18 weeks now and going for another MFM appointment next week. You will be AMAZED at the clarity of the ultrasounds (at least compared with those in my regular OB's office).
I never really seen a high risk doctor as my OB had dealt with many T1 diabetic patients. She also was able to deal with my diabetes as my endo decided to be a complete jerk about the pregnancy. I have an endo now though.
As for questions my OB had me do an ultrasound that would look at the baby’s heart later on. I also had visits every two weeks from 30 weeks on and an ultrasound every two weeks plus NSTs twice a week at 32 weeks and on. That was due to my pre-eclampsia though.
I have had one successful pregnancy. I would also ask Kidney screaning throughout, I only say that because my dr checked mine through blood work every month and I had 2 24 hour urines, not because there was anything wrong with my kidneys but just to keep an eye out. Also ask about weekly fluid U/S during the last few weeks. Other then that I think the other poster answered a lot of the really really important things you'd want to ask. With good control and good monitoring and a Dr that works with you, you will most likely have a wonderful pregnancy. Hopefully you can build a good trusting relationship with your dr, it helps so much to have that. :)
I've wondered before if it's only me that doctors treat like crap. Of course it's not. Right now I am actually under the care of a pretty nice and understanding endocrinologist, but that has not always been the case. I've been almost in tears because of how some endocrinologists, regular doctors, and even nurses have treated me. They seem to have no sympathy. Many are very stern and don't even want to listen sometimes. I've always tried my best to be under control and it seems doctors will still go on and on about how control can be better and make the patient feel so bad about it. THEY should try balancing injections, blood tests, and diet. Geez. It's easier said than done.
I am glad you're switching doctors though. While I'm with a great endocrinologist right now, the high risk doctor that does my ultra sounds likes to lecture me about diabetes. I have heard these same speeches for the last 18 years so I kind of just sit there and nod. I have had great control this pregnancy and my blood sugars are always in the low 100's. She seems to want to keep me at 70 though and talks to me as if I have gestational diabetes or type 2. I have type 1...
I guess what I'm trying to say is- it's hard to find a good doctor that understands...It's also hard to find a doctor that actually spends some time with you and answers questions. So many doctors are just in and out with their patients. Questions you could ask is how big the baby is since diabetics seem to have large babies and ask if the fluid level is alright because diabetics also commonly have exccess fluid. Actually, you probably won't have to ask these things, the doctor should make you aware of these things if he/she sees them present.
I don't understand why the doctor said don't put diet coke in a kids bottle? Not that I'd give a kid soda, but was that supposed to be a joke? I don't get it? and crack? Really?
You are by far not the only one. When I was first pregnant with my daughter the one OB I seen was nasty! He scolding me all the time for sugar levels in the low 100's he would yell at me and tell me they were still to high! My A1C was below 7% and he told me it need to be 4%. I was like well that is really really hard for a diabetic to reach, heck 5/6% is awesome! In fact my endo was pleased with my numbers and would reassure me that it was ok and to not pay any mind to what the OB was saying. In fact at one point he wanted me to take fast acting at bedtime!!! FAST ACTING!! I was like well I will not make Insulin changes without first consulting my endo and that made him mad too! Everytime I would have an appt. to go see him my blood pressure would go up, then I'd get a higher reading in the office, but I didn't have high blood pressure. The final straw for me was when he came out and just said that Diabetic women shouldn't have babies because it is just to risky for everyone involved! I was done with him after that, I switched to the other OB in the practice and I told him everything! I was about four months along when I switched OBs and the second was amazing!!!! He also said there is no reason a Diabetic can't have a baby, sure it is risky but many do and have uneventful pregnancies. Which I did have an uneventful pregnancy! It wasen't too long after I delievered my daughter that the other OB left the practice. I found out later that many many others had issues with him to, and even the to OB's didnt' get along well. I am so blessed to have a great endo and a great OB, I better get on it so I can have him again, I could not imagine going to anyone else!:)
