Any tips for questions to ask the Doc at a pre ttc visit?

[Kadinga]

Hi all,

I'm posting my list of points to cover with my doctor and I'd appreciate any tips anyone has to offer.

Just some background.... I live in a rural area and options are limitted. Last time I had shared care between:
My OB - neccessary for a non-optional planned ceasar but low on people skills and old-fashioned. He's the only one locally that can/will do a ceasar, so he's not an option.
The midwives - can't write a prescription, but emotionally good value.
My GP - she was in her final year residency, interested in OBs and the only one willing to try anything stronger than maxolon. She was and is an angel of mercy, but she's moving away!!!!!

Next week I'm seeing my GP. First, I'll be going over my general health and detox plans with her, but I'll also need to ask her about a reccommendation for someone else in the practice who will be as supportive and positive as she was. I will then be making an appointment to see this stranger ASAP, as I want to start ttc in May.

So far, my list of concerns includes
Is this new person intending to STAY? I don't want to have to keep starting fresh all the time.
Do they have experience with HG? Including do they acknowledge that it's different to normal morning sickness.
Do they understand that I will only be wanting meds when and as I really need them? I am not a hypochondriac and I am not being "weak".
Do they agree with my meds protocol?
Do they agree with, or at least understand, my dietery protocol?
Do they agree that the biggest goal for this pregnancy is to prevent the need for overnight stays in hospital by getting me in earlier rather than waiting until I faint in the doctors' office?

That's it at this stage.

If anyone has any tips or other feedback I'd be really glad to hear from you.

Amanda

Mum to 1 HG darling - Heather b 9/15/2003
planning to ttc in May

[bibliojo]

Hey Amanda,

Here is a link to a list of questions you can ask you doctor.

http://www.hyperemesis.org/mothers/refe ... doctor.php

To your list of questions I would also add when you do seek hydration (is it after 24 hours of not keeping anything down, 48 hours? etc) and what will they do if certain meds are not working. That's all I can think of at the moment but will post again if I think of anything else!

Good luck! Finding a doctor is hard work but so rewarding if you find someone who will take you seriously and be aggressive with treating the HG!

Joanna

[emmasmummy]

Hi I am from Australia too!!

Do they have an oncall GP that you can ring at anyhours when/if you dehydrate fast? Are they available to discuss drug options on the weekend if you need to increase the dose. MY OB gave us his mobile number so we could contact him direct after hours.

I do feel it is important that they fid you ONE point of contact.

Do you have Private Health and can choose an OB or do they have a public OB that is trustworthy/reliable?? Or someitmes the midwives can have the greatest influence on them!!

Take Care .. I am on my first cycle ttc again but have had the same OB the last 3 times so a bit easier for me to manage .. good luck!!

[Kadinga]

Thankyou both,

Joanna, I've had another look at that link, and it is very helpful. I've added a few extra things from that.

Chris, The point of phone contact is a valuable one. I'm 55km out of town and really hated dragging myself in (driving not a good idea while incredibly vague) everytime I needed anything.

I do have private cover, but if I don't go with the one local OB I have to drive 2 1/2 hours to the next nearest... not really a good idea, so I'm just sticking with mine from last time. He has a very strong preference for herbals (not helpful, too stinky and the pills are too huge) and really didn't like me being on the prednisolone last time, which is why I was greatful for the more sensitive GP. If only she wasn't getting married and moving!!!
Last time, one midwife told me to stay horizontal for a bare minimum of 10 minutes after taking the maxolon if I wanted it to work, and it remarkably better after that, so I'm sort of hoping that if I start out that way this time things won't get as desperate as they did last time, which will solve a lot of problems with the selection of available care.

My appointment is on Wednesday, and I'm actaully now thinking about asking for a meeting with the OB and GP together, just to solve the "He said, she said" issue. I'll let you know what happens.

It may be childish and foolish, but we can always live in hope!!

cheers

Amanda

1 HG darling, Heather 18 months
ttc in May

[bibliojo]

Amanda,

Just wanted to say good luck at your doctor's appointment on Wednesday (I hope it works out that you can get the GP and the OB together -- great idea!) Let us know how it goes!

Joanna

[emmasmummy]

Thinking of you for your appt today ???

Will they let you use zofran?? .. not really a wonder drug as such for me in the respects of getting out and about and feeling wonderful but it got me off the floor enough to look after my kids for the time my dh was at work.

Hope it went well ....

[Kadinga]

Hi Chris & Joanna,

So far so good....

GP (the one who is leaving) agreed with most of my plans, took notes the whole time, is going to type up a formal plan for my file and send me a copy for approval. She's also going to meet with the only other two doctors in the practice who have insurance to see pregnant women (one of whom is my OB) and discuss the best options for treatment with respect to the plan and get back to me with regard to who is going to be my first port of call. (OB doesn't actually consult everyday and isn't very easily available, but when I know who I'm "working with" I'll follow up on your phone number plan, Chris)

My big plusses are that I have a prescription now (not even ttc yet!) for maxolon, which I know doesn't usually work and didn't for me early on but it did after I learnt to never be vertical within 15 minutes of taking it. (This could have had something to do with the steroids, B6 and IV I was on at the same time!?!?!?) We've agreed that I can start it as soon as I start vomitting.

Chris, I have never tried or been offered Zofran before, and that might be worth having a go at if the maxolon is a complete failure at the start. Anything to keep myself out of the wards!

We've also agreed that I can test myself for keytones and take myself direct to the hospital for a couple of bags of fluids the instant I get a positive keytone result, saving the waiting to get in to the doctor. She's going to make sure I have a letter to take with me if that occurs.

The only thing she didn't agree with me on is that if I need 24 hour IV then she wants me in hospital resting, not at home carting an IV pole around after my toddler. This maintains the problem of no one to look after Heather for full days, but I can see her point.

So, at this stage I'm not in control of who I'll be relying on, but my lovely doctor (who has asked about this site and is coming to check it out) is making sure that everything that can possibly be done for me is happening.



hope all is going well with you two.

love

amanda

[bibliojo]

Amanda,

I'm glad your appt with your dr went so well! It's great to have a dr that is so proactive isn't it? I hope that she will be able to get the drs that will be actually treating you on board too.

About the IV fluids and being hospitalized...hopefully your HG will be treated agressively enough that you won't have to get to this point but if it does, your dr does have a point. Don't try to be a supermom! You have to take care of yourself and realize that when you have HG you can't do all the things other normal pregnant women can do. Can you make some arrangements before you get pregnant just in case you might have to go into the hospital when pregnant? Then maybe you won't be so stressed out about seeking the care you need to get through the HG.

Best wishes to you!

Joanna

[Kadinga]

Hi Joanna,

You are so right about having a proactive doctor. It makes so much difference when you are trying to keep your confidence up. I told her about the "find a local doctor" page on this site and that I thought of putting her up here, as there are only about 3 listed in Australia. I think that might be one reason she was keen to have a look at the site.

I know that you are right about being put in hospital. Super Mummy Sydrome had a bit to do with why it got so bad last time. My problem for care for Heather starts with neither my mother or mother in law as options for care for her, in our home or theirs. Mine is deafer, blinder and more easily confused than she'll admit to. It might be okay with Heather in her own environment (our home) but I'd need to know that Mum wouldn't try to drive her anywhere. I have real paranoia about that. My M.i.L. works a lot and spends a lot of time preoccupied with her new boyfriend, and when she spends time with Heather she shows no interest in actually playing at her level, which is obviously just who she is. We're too far out of town for Troy to be able to drop her at a care centre during the day. The best option I have been able to think of is that he takes her to a friend's house just up the road where there is a little boy her age, but I'm wary of overstretching that friendship.

You're right, though. I'm going to have to get something figured out that I can live with.... get over some of my hang-ups.... some sort of back-up care has to be better than nothing! Maybe I can get my Mum to promise not to drive, and Troy could drop in for lunch every day to keep an eye on them......

or maybe things won't get out of hand, and I won't have to worry!!!!!!

(....hopeful face....)

take care


Amanda

[bibliojo]

Amanda,

This does sound like a difficult decision for you to make! But just because you have a plan in place doesn't mean that you will have to act upon it! It's just something to fall back on if you really need to. You can also divide the care of your daughter among your mother, mil and neighbour so that then nobody gets too overwhelmed caring for Heather. Talk to them and see what they have to say. You might be surprised that your neighbour may be willing to take Heather a couple days a week in exchange for some babysitting done by you (when you're well of course!) And if Heather and the neighbour boy are close in age, they will probably have a lot of fun together! Heather is probably getting to the stage where she's starting to notice other kids and wants to interact with them! It just may distract her somewhat from the fact that mommy is sick.

Good luck deciding, BUT of course, I really hope for you that whatever is decided upon won't have to be acted on!

Joanna

[RebeccaM]

Amanda,

I just noticed your little darling was born the same day as mine! That's neat! Such a fun age. Best of luck with you're planning.

[Kadinga]

Joanna,

Once again, you are so right.

Sharing out the care is a good idea, also adding in my husband, as we tried sending Heather out to round up sheep in the ute with him on Saturday and she loved it. This will clearly be a good plan for while I'm at home, so that she is not constantly exposed to my condition. Easing the pressure on me may also help to keep me out of hospital.

Once my mother comes in to the picture, though, she's there 24/7 for at least a week at a time as she lives 3 1/2 hours away; too far away to come and go. She hasn't driven more than an hour on her own in years and I think my father prefers that she doesn't try as I think he's similarly aware of her vagueness. It might be worth having her here while I'm at home, too, except that we clash so badly that I'm afraid of her making me worse.

At this stage, I think the best option, should I end up in hospital, will be to have my Mum here, but ask as many people as possible to drop in as often as they can.

cheers

Amanda
1 HG angel, Heather, 9/15/03
planning to ttc in May

[Kadinga]

Joanna,

Once again, you are so right.

Sharing out the care is a good idea, also adding in my husband, as we tried sending Heather out to round up sheep in the ute with him on Saturday and she loved it. This will clearly be a good plan for while I'm at home, so that she is not constantly exposed to my condition. Easing the pressure on me may also help to keep me out of hospital.

Once my mother comes in to the picture, though, she's there 24/7 for at least a week at a time as she lives 3 1/2 hours away; too far away to come and go. She hasn't driven more than an hour on her own in years and I think my father prefers that she doesn't try as I think he's similarly aware of her vagueness. It might be worth having her here while I'm at home, too, except that we clash so badly that I'm afraid of her making me worse.

At this stage, I think the best option, should I end up in hospital, will be to have my Mum here, but ask as many people as possible to drop in as often as they can.

cheers

Amanda
1 HG angel, Heather, 9/15/03
planning to ttc in May

[bibliojo]

Amanda,

That sounds like a great plan! You've seemed to have thought of all the pros and cons!

On a side note, I love both yours and Rebecca's new pictures of your dds! They are both so very cute and adorable. I also might add that share the same birthday as Heather and Tierra! I was born on September 15th too!

Joanna

[Kadinga]

September 15 must be a magical date for lovely little angels to be born.

Seriously, what a coincidence!

Thanks for all your input. It's funny how discussing things with other people helps you figure out a solution that was right there the whole time. I actually feel a lot better about it all now, and more able to just relax and wait and see, which is what my dh has been wishing I would do all along.

[bibliojo]

Amanda,

I'm glad you've reached a plan of action that you are happy with! How are all your other preparation plans coming along? I have just been hit with the realization that May is not all that far away and I have a million things to do before we start to ttc! But at least keeping busy has kept my mind occupied and not dwelling on the terrifying thoughts of facing HG again so I'm not completely stressed out!

Joanna

[Kadinga]

Joanna,

Ooooooh, the other plans......

Well, the "detoxing" is a little harder than I expected. I must have an adictive personality because giving up some things is really hard. I realised I was drinking 6 or more coffees a day, and I had to wean myself off them slowly as the cold turkey approach turned me into monster mummy. I'm now up to day five of no coffee and I only had two teas yesterday. I'm leaving my run a bit late, May being as close as it is, (totally agreeing with you on the ) but I only got the idea when I found this site a month ago. Still, I figure I won't be adding caffeine withdrawal to the general feeling of sickyness, and maybe that will make a big difference.

My freezer stock is growing, although persuading my husband not to dip into it is a bit tricky. My menus and shopping lists are also nearly finished. I've kept things as simple as I can there, because I figure too much variety takes a lot of thought. I think, though, that feeling like I'm still taking care of those basic needs for Heather and DH will help me feel better about things in general.

I've been taking my 5mg folate for 6 weeks now, and I think that it's upsetting my stomach a bit, so that doesn't bode well, but I'm contemplating taking a partial risk and reducing the dose to the normal people's level once the vomitting gets serious. I figure that a smaller dose that stays down has to be better than a larger dose that doesn't.

I also read an interesting post about potassium on the boards somewhere, and remembering that in my second visit to hospital last time my third IV bag was potassium, I've decided to ask for my potassium levels to be checked every time I go in this time. I've also looked up potassium foods in a book I have called "The Food Doctor", so that I can charge up before the vomitting really hits. It was interesting reading, as a lot of foods that I generally like are apparently diuretic or laxative, which clearly won't help, so I've added them to my personal "Blacklist". There are also foods in the potassium list that are supposed to be cleansing or that aid digestion that I might experiment with pre-HG and when the HG starts to fade as well.

How about you? Your protocol was very detailed, it must be keeping you very busy.

By the way, if in your HG phase you ever find yourself running out of colouring-in resources for Lukas I have a couple of web adresses where you can print off heaps of pages, some of which turn into fun stuff like masks.

Amanda

[bibliojo]

Amanda,

To be honest, after I meet with my doctor in Feburary and finalized all my treatments plans with him, I haven't really looked at my protocol! I've been taking all my vitamins/B6/folic acid for over 6 months now so I'm hoping I have a good enough store built up. I've been focusing more on getting my household ready for me being out of comission for at least 3 months. I've starting organzing everything so that people who help us out can find things easily. I have a huge grocery list of things to buy yet so hopefully my DH will only have to buy milk, eggs and fruits and vegetables while I am sick. I still need to defrost the freezer but I have a few meals stocked up in there. I'll add to it some more over the coming month. I've found lots of books and videos at swap meets to entertain Lukas while I'm sick. And we have friends and family lined up to help out too. So all in all, everything seems to be falling in place. There's still a few more things that I would like to get done but that aren't crucial. I'd like to get Lukas' baby book officially completed and I have a birth sampler cross stitch that I've been working on for over 2 years now for him that I'm almost done. I'd also like to get his pictures organized and in an album as I don't imagine I'll have time with two kids to keep up with that sort of thing. But overall, feeling pretty prepared or at least feeling that I will be able to get everything done in time to ttc. I figure if I get pregnant this month I will have 5 weeks left from now of HG free time! I'm going to enjoy this time and make a special effort to do fun things with Lukas so that I have some fun times to think about when in the midst of HG.

Well, good luck with all your plans. Hopefully we'll be pregnant together so we can support each other some more!

Joanna

P.S. I'd love to know the web addresses of those print and colour sites and I'm sure there are other ladies here too that would be interested.

[nomore]

Joanna-

Did you take the plunge and start TTC this month?????? I hope it goes well for you. We are still waiting till next month, even thoguh I know I know I am right around ovulation time right now. We will wait...lol.. at least till we really are in May!!!!!! Want to finish a few more allergy treatments before we start, and dont want to worry about being prego on our vacation to Disney!

Sending baby dust ......

Robin

[bibliojo]

Robin,

Yes, I am officially ttc!!! But I probably won't be ovulating until the first week in May so it's kinda technically May.... We decided to go a cycle early because my sis is out of school now until the end of August and we'd like to take full advantage of her offer to help. Plus too I'm guessing that Luke will get into speech therapy in September and if I get pregnant right away I could have the worst of the HG out of the way then so that I can help in his speech therapy. There's lots of little factors like this that go into this decision. I personally would prefer not to have a January baby (the baby would be due late January if I concieve this cycle)but us HGers can't be too picky when it comes to timing these things! I figure if I have help now to get me through it that would be better than not having help but having a baby when I want. So here goes it...I'm not too scared yet. I've just been panicking about all the things I have to do yet to be "ready"!

Have fun at DisneyWorld....you'll be joining me yet!

Hugs,
Joanna