Appt. with obs. consultant - what do I ask?

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Appt. with obs. consultant - what do I ask?

Postby moimoi » Jul 06, 2007 3:47 pm

Hi

Not posted for a while - we're still getting up our nerve to TTC again .

My previous HG was pretty bad but I had a very sympathetic GP and ended up on Zofran after many other meds failed to work - plus - 8 days in hosp.

Anyways - I went to my GP and discussed TTC and all the implications . She was great - did the Heliobactor(sp) test and reassured me - and this is the biggie - that SHE COULD AND WOULD PRESCRIBE ME ZOFRAN AS SOON AS HG KICKS IN NEXT TIME ! :D

She also arranged an appointment with our obs consultant to go through my previous pregnancy notes.Got the date for the appt . this morning and now my mind has gone blank ??

What should we be asking/discussing ?
I feel a bit silly now 'cos the GP was so good so I don't know if I really need to see the consultant at this stage .But I'm loathe to give up the appointment now I've got it IYKWIM ?

So - any tips?

Thanks
Moimoi

PS I am taking b6 and milk thistle as prep too.
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Postby Mom to Aidan & Daniel » Jul 08, 2007 12:28 am

Hmmn, since you got the Zofran guarantee, not sure either. Maybe just impress upon him\her how serious your HG is and that you need support\hospitalization and immediate appts. should you need it?

:hugs: :hugs: :hugs:
Sarah
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Postby Atsie » Jul 08, 2007 5:28 am

I would read the treatment page. See what she feel comfortable with.

Here is a list of questions to use to interview a Dr.

How many women do you see with HG each year?
(If they say only a few, they may be uncomfortable being aggressive early on, or may not realize how sick you are until you are very sick.)

What do you think causes HG?
(If they say it's largely psychological or they don't know, find a different doctor.)

How do you treat HG?
(Allow them to respond to this before asking the more specific questions listed below. Determine if they have a preset plan or if they treat based on your individual symptoms and response.)

Do you always start with Phenergan, antihistamines (Unisom) and/or sedatives (Compazine)? Or can I start with the medication that worked best last time (or a different one if nothing helped)?

At what point can I start on a medication?
(It's important that doctors are willing to prescribe medications when symptoms begin since you have had HG in the past. This may prevent complications and make HG less severe.)

Do you use Zofran, Kytril or Anzemet? How many weeks do I have to be to start on this medicine? What is the dose you feel is the most I can take in a day?
(It is a misconception that no drug is safe until after the first trimester. Refer to our Risks and Outcomes page for more info. See our Medication page for dosages.)

If I don't improve with those drugs, what would be the next step?

Do you ever use steroid therapy?
(If you have severe HG and/or have not responded to medications in the past, you may want to consider this. Review more on it on our Medication page.)

Do you prescribe home TPN or other options for nutritional support? If so, at what point (how many pounds do I have to lose, how long do I have to vomit, etc.)?

What other options do you recommend for treatment besides (or in conjunction with) medications? (e.g. Acupuncture, homeopathy, gastric pacing, psychotherapy)

Since I have had HG before (or now) and we are trying to get pregnant, can you give me a prescription for a few doses of (the medication you want to try first) to have on hand in case the nausea/vomiting begins while you are not available or I am away from home (if you travel).
(If another doctor is on call, they may not be willing to offer you medication without first seeing you.)

Are you comfortable with my using homeopathics or other natural treatments?
(If you plan to try them. See our Complementary & Alternative Medicine section.)

What are my options for contacting you after hours if I am getting worse since you will know my condition best?
(Do you have to talk with the nurse or an on-call person first? Is that your only option?)


http://www.helpher.org/mothers/referral ... doctor.php

Good Luck!
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Postby sarahkate » Jul 08, 2007 12:56 pm

I'm sorry it's taken me so long to reply, we have been on holiday.

That is wonderful news about your GP.

I agree, it is still worth going to the consultant obstetrician. Just to check that they are happy with that being the plan, and things like when to admit, when s/he will see you in clinic, what other screening they do (eg. growth if HG severe, electrolytes, etc)Did you have any other pregnancy problems?

The licensed dose of ondansetron in the UK is 16mg - many need more - would your GP prescribe this?? I would imagine a consultant's say so would be preferred. Certainly steroids as Erin mentioned is a consultant only.

Have you had a nose at the sticky at the top of this folder?? It may add more.

How are you feeling about ttc? If we can help with any thinking we are here.

Sarah xxx
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Postby moimoi » Jul 09, 2007 3:16 pm

Thanks for your replies , guys . :)

DH and I will go through the stickies and make copious notes to take with us to the appt.

I have heard that Zofran is available in a dissolvable form - I'll ask the consultant about that . There's little point in them prescribing Zofran tablets if I'm just gonna bring them back up again - especially at £25 a pop ! :wink:

Am feeling a mix of excitement and nerves at TTC.
We have put off TTC for obvious reasons - I would really have liked a smaller age gap between siblings but have come to terms with it being a bit wider - it's not such a big deal.

We have also been very busy renovating a house which we will finally move into at the end of the month - TTC while that was going on would have been crazy .
The house move will also mean being further away from my lovely GP - but I really do not want to risk changing surgeries at this stage.

And sadly there has been some pretty critical illness in our close family so family support would have had to be limited .

I thinks I am most worried about the effect on DD (now aged 2 1/2).She's a real star but is also quite a sensitive soul. We are lucky that she adores my mum - and the feeling is mutual . And the new place will have a spare room so helpers will be able to stay over .

Sorry this has ended up so long . Have a gold star if you are still reading !

Moi
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Postby Natalie » Jul 13, 2007 1:29 pm

Hi there,

I didn't reply to this thread because I felt the other ladies had pretty much covered everything.

Having said that - when is your appt.? Do update us with how it goes.

Natalie, x
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Postby Susannah » Jul 23, 2007 1:24 pm

:hugs: Thinking of you. How did your appointment go?
Susannah
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Rose became our angel 8/2/07
Grace born at home 5/23/08 HG 7 weeks-delivery

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Postby moimoi » Jul 26, 2007 3:25 pm

Appointment is tomorrow morning so I'm trying to get my head ready for it !

Will make notes and go through them with DH so he knows the game plan .

We move house next week so may also have to change GP . Am reluctant to do this since my current GP is a star but we will be living 25 min drive away . :(
I'm not sure what to do - I'm worried if I change GP I may end up with an unsympathetic one .

But , I guess , if I get the consultant on my side now (fingers crossed) then that would help.

Will let you know how it all goes .
Thanks .
Moi
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Postby Natalie » Jul 27, 2007 3:59 am

Oooh, hope it goes ok.

Do update when you can!

Natalie, x
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Postby sarahkate » Jul 27, 2007 9:07 am

Thinking of you today. And with you on the moving and not wanting to change GP.

Sarah x
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Postby mandy » Jul 27, 2007 1:09 pm

I hope it went well today. x
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Postby Natalie » Jul 27, 2007 1:14 pm

Any news???
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Postby moimoi » Oct 22, 2007 4:04 pm

Hi ,
So sorry for disappearing for so long .We did a big house move and have had lots to sort out .

Been trying to settle DD into playgroup with limited success. :(

Well, we saw the consultant and she was very nice . She did the whole , 'you may not get HG again ' thing , but seemed to understand our concerns.

She agreed that getting ondansetron ASAP would be sensible and wrote a letter saying as much . We now have a copy of the letter with her recommendations and their should be a copy in my medical records for my new GP to see. :)

Part of the letter DOES say that we could try Stemitil in the first instance however this was pretty ineffective last time so hopefully I would still get the ondansetron pretty quickly .

We have now started ttc . Haven't had much success for the last couple of mmonths which is a bit frustrating since it happened really fast with DD.
I just need to be patient , but because of the potential HG I get a bit obseSsed with trying to plan it so that it would cause minimum disruption IYSWIM ?

So there we are .Just need to get DD settled into playgroup or nursery , then potty trained - and then the fun can really begin ! :?
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Postby Lil7Deb » Oct 23, 2007 11:27 pm

Hi - Looks like you've had some wonderful appointments. I'm very thankful you look like you've gotten some excellent help from your dr's.

My DD was a sensative 2 year old when we got pregnant with my son. I was SO worried that she would struggle with my pregnancy. I was just amazed at how resiliant kids are. She found the fun things and just went with it. It was even great when I was having a really hard day because she could tell.

I just wanted to encourage you, and maybe help relieve your fears some. I know I had many about the wellbeing of my DD. She's 4 now, and I'm amazed that she has little to no memory of it.

Hope things go your way! Good luck with the Potty training. I find that particular aspect of parenting so difficult!
Deborah

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Postby Natalie » Oct 24, 2007 3:36 am

Hi there,

Well that does sound like a very productive OB appt. :D I'm not surprised she wanted to give you a shot on the Stemitil probably just to rule it out that it deosn't work. I guess it'll become pretty clear sooner rather than later that it's not doing the trick.

Good luck with the ttc. Do pop over to the TTC folder - there are a bunch of lovely ladies in there ttc and all going through similar emotions to you every month I should imagine.

Keep us updated.

Love Natalie, x
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