Should I get a second opinion?

[plenilunio]

Hello and Happy Friday! I am currently 16 weeks pg with #2. I experienced general queasiness and occasional vomiting during my first trimester, but I had really started to feel better. I just spent 3 weeks in Cuba visiting the family and I feel like I might have caught some sort of food-borne bacteria while I was down there. I was fine the first day back, but then I started to experience intermittent cramping in my pelvic area and have now had diarrhea for the past 3 days. On the first day of the "runs", I also had a couple episodes of morning sickness-like nausea and vomited once. No fever, though. I saw my OB for a regular check-up yesterday and described the symptoms. I also mentioned that I had been peeing more often than usual these past 3 or 4 days. He said I might have a UTI (even though I have no burning feeling when I urinate) and prescribed nitrofurantoin, which is a urinary germicide and classified by the FDA in pregnancy risk category B. The doc says the drug is completely safe and that, even if I don't have a UTI, it's better to be safe than sorry, as an untreated UTI could induce preterm labor. I am the type of person who is very hesitant to take medication even when I'm not pregnant, and I am especially scared that taking this might not be the best idea for my baby. I already filled the script this morning, but have not yet taken the pill. I don't know who to call for a second opinion, as OBs around here (Miami) are not exactly receptive to phone calls from non-patients.. Any thoughts/similar experiences with diarreah, food poisoning and UTIs? I have been taking in lots of fluids to avoid dehydration.. Thanks and congratulations on your pregnancies!

[homemademom]

Congrats on your pregnancy! I would get a second opinion. A test for UTI is not hard; they just need a urine specimen. I don't know why your doc wouldn't just test you to be sure. I've gone in to quick care/urgent care for suspected UTIs, no need to talk to my regular doctor.

Make sure to stay hydrated with the nausea and diarrhea. Good luck with every thing!

[MaerynPearl]

While you do NOT have to have symptoms of a UTI to have one (especially in pregnancy, trust me! Ive had several with no symptoms at all) I would question treating you for one without even testing for it!

[Banana731]

He definitely should have tested your urine before prescribing antibiotics. Is this your regular OB? I would definitely get a second opinion. Go to the finding your tribe area of MDC and ask for some recommendations, there must be a ton of OBs in Miami. I'd be wary of a CP who is so quick to through meds at a problem. It's not a great way to be in general, but in maternity care it's a disaster waiting to happen.

[dejagerw]

You could always try back at your same Dr., saying you're not comfortable taking the drug until they actually test you for a UTI. Sometimes doctors just prescribe stuff because that's what the majority of the public would prefer. A lot of people don't have the same mindset as the people on these boards, and they'd just as well take a pill, rather than a test, and wait for results.

Good luck!!

[~Adorkable~]

Luna, first off welcome to MDC! Please come over to your due date club and join up, I assume from your timing you are due sometime in Jan?

As for the uti I agree get it tested, I just had one and did start meeds before the test was back but only because I had all the classic symptoms and was miserable. I still had them test to make sure we covered our bases and it was not anything else that needed addressing.
When you say you been peeing more than normal, has it been a normal amount each time or the urge to pee a lot but not usually a lot coming out? The later is a uti symptom, the former may be a kidney thing but I know less about that.

In the larger picture yes a lot of doctors have been sadly trained by the public that what most folks want is drugs, a quick fix, not details or a real understanding of their bodies.
I usually start with a new doctor by telling them that I feel drugs should be the last step and understand the root of an issue should be the first. That I care more about cause than symptoms, usually I find they are happy and find this refreshing, sometimes I see them scoff at this approach and then I know I need to talk to a different doctor.

[babymango]

At my first Dr visit, I did a urine culture that came back positive. The nurse called me to tell me the doc had called in a prescription to my pharmacy. I had no symptoms and was not happy about taking antibiotics during pregnancy. I asked the nurse if she knew which bacteria was growing, and she told me it was a gram positive, but couldnt tell me which one as it hadn't been identified. That made me very uncomfortable about taking the antibiotics as gram positive bacteria are often skin contaminants (or GBS, which would be a different story). I know that asymptomatic bacturia in pregnancy (ABP) can lead to preterm birth, so i didnt want to ignore the test completely. I asked the nuse to have the doc call me back. When he did, I asked him to repeat the culture and to actually see what was growing in my bladder. If anything, the ACOG recommendations for ABP suggests waiting until TWO positive cultures before treating.
In the end, the doc agreed to repeat the culture and it came back negative. no antibiotics for me, yay!
So to answer your question, definately try and get a culture.

[plenilunio]

hey mamis! thanks for all the advice. i have actually been a member of MDC for years-- back in my single mothering days, i used to lurk quite a bit on the single parenting forum.. i couldn't remember my log in info, though, so i re-registered under a new name.
as for my little problem, the diarrhea finally started to improve!
i still wanted a second opinion on the UTI, so i ended up spending the day at the ER on saturday. the attending docs at the ER (a resident and his supervisor) were great! they were so much more attentive and responsive than my OB was. while they did reiterate that UTIs during pregnancy can indeed be asymptomatic, they were completely befuddled about the OB's decision to prescribe the antibiotics without at least checking my urine. so the first thing they did was give me a urine test, and surprise! no UTI. they also did some blood tests (all came back normal) as well as an U/S (no apparent inflammation of the appendix and baby looks great). they felt --as i always did-- that i had contracted some sort of gastrointestinal virus while in cuba, which was finally in its waning stages. sent me home with instructions to rest, hydrate and eat bland foods until i felt better. i need to call my OB to follow up today. i am going to follow •Adorkable•'s suggestion and first let him know that i am the type who sees the need for pharmaceutical intervention as a last resort. i will also tell him that i did not understand his decision to prescribe the UTI antibiotics without first testing me to see if i actually had an infection. depending on his response and how i feel from here on out, i might consider switching to someone else. the OBs who attended to my last pregnancy (and DS' beautiful, drug-free birth) had come highly recommended by my doula and were FANTASTIC. unfortunately, however, they do not take my insurance anymore, so my choices are more limited.. will keep you ladies posted. sending sunshine and sea breeze from miami for all your blossoming bellies! luna de acuario