Drs demanding too many u/s - Mothering Forums

Forum Jump: 
 
Thread Tools
#1 of 28 Old 05-17-2006, 12:57 PM - Thread Starter
 
Twice as nice's Avatar
 
Join Date: Feb 2006
Location: Sunny Florida
Posts: 762
Mentioned: 0 Post(s)
Tagged: 0 Thread(s)
Quoted: 0 Post(s)
I'm reposting this from my DDC in hopes of getting some more input... Thanks!!

Im having some huge issues with the ultrasounds my doctors are demanding. My OB is sending me to a perionatalogist b/c I'm having twins. I finally got a call today to schedule my first appt with them and was told that this u/s appt would take 2 hours because the u/s ordered by my OB is a "very detailed" one. Also, my OB told me the perionatalogist will *require* me to have an u/s every 4 weeks and that neither I nor he (OB) have any say in the matter.

Guess what I'm trying to get at... does anyone know who makes the decisions on the # & type of u/s ordered (OB or perionatalogist)... both seem to be blaming the other for requiring all of these ultrasounds? Also, if I refuse to have some of these u/s done, can either of the doctors refuse to see me as a patient? (this is the only OB practice in the area that is accepting my insurance and twin pregnancy, so I cannot afford to get booted out of there.)
Twice as nice is offline  
#2 of 28 Old 05-17-2006, 03:20 PM
 
SingSongMomma's Avatar
 
Join Date: May 2006
Location: Harpers Ferry, WV
Posts: 208
Mentioned: 0 Post(s)
Tagged: 0 Thread(s)
Quoted: 0 Post(s)
Hi there, I have 10 month old G/G twins and we had u/s every 4-6 weeks after my 18 week one... I never asked if I could not have them since They thought for a while they were sharing a sac, or a placenta and they are both such high-risks... Good luck and congrats!!!
Michelle
SingSongMomma is offline  
#3 of 28 Old 05-17-2006, 03:30 PM
 
royaloakmi's Avatar
 
Join Date: Mar 2005
Posts: 1,369
Mentioned: 0 Post(s)
Tagged: 0 Thread(s)
Quoted: 0 Post(s)
That schedule sounds commong, but I'm not sure why any ultrasound should take two hours unless the techs don't know what heck they're doing.

I had one to diagnose a possible miscarriage at 5.5 weeks, another at 6.5 weeks (when I found it was twins!).

My first "real" one at 20 weeks was longer (maybe 20-30 minutes?), but no big deal. After that I had one about every 6 weeks (they were quick, like 10-15 minutes, tops). My doc recommended every 4 weeks and I negotiated every 6 weeks.

Then at 36 or 37 weeks I started having them weekly b/c of some cord issues they were monitoring.
royaloakmi is offline  
#4 of 28 Old 05-17-2006, 03:37 PM
 
CryPixie83's Avatar
 
Join Date: Jan 2004
Location: drifting away...
Posts: 3,163
Mentioned: 0 Post(s)
Tagged: 0 Thread(s)
Quoted: 0 Post(s)
If you're not comfortable with so many ultrasounds, refuse them. You have the right to refuse any "routine" procedure and they can't force you to have them done. If they give you grief, remind them that they work for you and can be replaced.
CryPixie83 is offline  
#5 of 28 Old 05-17-2006, 04:39 PM - Thread Starter
 
Twice as nice's Avatar
 
Join Date: Feb 2006
Location: Sunny Florida
Posts: 762
Mentioned: 0 Post(s)
Tagged: 0 Thread(s)
Quoted: 0 Post(s)
Quote:
Originally Posted by CryPixie83
If they give you grief, remind them that they work for you and can be replaced.
Thats one of my problems is that I cant replace them, unless I want to pay the entire fee out of pocket (they are the only practice covered by my insurance that havent refused me as being "high risk")
Twice as nice is offline  
#6 of 28 Old 05-17-2006, 04:53 PM
 
hotmamacita's Avatar
 
Join Date: Sep 2002
Posts: 7,210
Mentioned: 0 Post(s)
Tagged: 0 Thread(s)
Quoted: 0 Post(s)
I cannot tell you what to do but I can tell you what I did.

3rd pregnancy. Big cross country moved occured. At 21 weeks, I finally got around to finding a midwife. She hears two heartbeats and asks if I am open to an ultrasound. She knew we didn't do US wwith previous baby.

I was primarily b/c I wanted to rule out polyhydramnios which could have risked me out for a HB. I didn't really think I could have twins although I WAS measuring BIG. Anyway, at 22 weeks, I go in for a US and in the first minute the technician says "Oh there are twins, I wish someone wowuld have told me" And she leaves the room to reschedule the patient after me. She comes back in, we are jumping up and down and all excited. My other two children are excited. Technician asks me to lie back down and she proceeds to do a long 2 hour US which we didn't realize.

She did her whole thing and they are fine at that point. No problems at all. She says that she'll see us frequently because it is standard to come every 2 weeks at this point.

We never went back.

Now we also weren't in a doctors care but found a midwife many weeks later and got a peri to back us up.

If I were in your shoes, I would talk to the peri directly and share with her your concern and gentle delay of US. I'd see how she reacted, how I liked her and howw open she was to respecting my medical choices. A really great medical relationship could emerge from this.
hotmamacita is offline  
#7 of 28 Old 05-17-2006, 05:18 PM
 
alegna's Avatar
 
Join Date: Jan 2003
Posts: 44,408
Mentioned: 0 Post(s)
Tagged: 0 Thread(s)
Quoted: 0 Post(s)
You can refuse anything and everything. Don't ever let them tell you otherwise.

-Angela
alegna is offline  
#8 of 28 Old 05-17-2006, 05:26 PM
 
royaloakmi's Avatar
 
Join Date: Mar 2005
Posts: 1,369
Mentioned: 0 Post(s)
Tagged: 0 Thread(s)
Quoted: 0 Post(s)
If you seriously think you might get booted from the practice and don't have other options (and don't feel comfortable negotiating a different schedule and being upfront about it - which would be my first option), you could just be kinda passive aggressive about it and be lazy about scheduling.

You know, don't return the phone call for a few days, have "conflicts" with scheduling, cancel appts. with adequate notice (and reschedule for a later date). That kinda thing. You could probably get by with many fewer us's over the course of your pregnancy.

Also, as Angela said, you have the right to refuse anything you're not comfortable with.
royaloakmi is offline  
#9 of 28 Old 05-17-2006, 05:34 PM
 
JoyofBirth's Avatar
 
Join Date: Mar 2004
Location: Arlington, Texas
Posts: 1,427
Mentioned: 0 Post(s)
Tagged: 0 Thread(s)
Quoted: 0 Post(s)
You do have the rightt to refuse any medical service they request. They also have the right to choose not to provde your care. THey generally refer to it as risking out the practice.

Jessica, mama to Emma, 7, Mattie, 5.5 and Lilly, 3 and someone new this Halloween-ish.

JoyofBirth is offline  
#10 of 28 Old 05-17-2006, 05:42 PM
 
amnesiac's Avatar
 
Join Date: Dec 2001
Location: at the end of the longest line
Posts: 4,984
Mentioned: 0 Post(s)
Tagged: 0 Thread(s)
Quoted: 0 Post(s)
I only had one at 20 weeks. There wasn't a reason for more.
amnesiac is offline  
#11 of 28 Old 05-17-2006, 05:51 PM
 
alegna's Avatar
 
Join Date: Jan 2003
Posts: 44,408
Mentioned: 0 Post(s)
Tagged: 0 Thread(s)
Quoted: 0 Post(s)
Quote:
Originally Posted by JoyofBirth
You do have the rightt to refuse any medical service they request. They also have the right to choose not to provde your care. THey generally refer to it as risking out the practice.
I THINK they have to refer you to someone else. And I KNOW they can't drop a pregnant woman after a certain time (30 weeks?) without providing another caregiver.

-Angela
alegna is offline  
#12 of 28 Old 05-17-2006, 06:32 PM
 
mamajody's Avatar
 
Join Date: Jul 2004
Location: New Britain, CT
Posts: 1,704
Mentioned: 0 Post(s)
Tagged: 0 Thread(s)
Quoted: 0 Post(s)
HATAWA,

it sounds like they are sending you in for a level 2 U/S. One of my friends just had one and said it DID take 2 hours. Mine is next week so I will let you know. I have also been told I will have very frequent U/S toward the end of the pregnancy to monitor position and cord issues. My practice will only attempt vaginal delivery if A is vertex and no cord issues are present. B must be vertex or breech at the onset of labor because they won't attempt a version mid-delivery. The way I see it is they are going to do an U/S at the onset of labor to confirm position so I could just wait, but I would rather be prepared for the birth ahead of time, so I will consent to more frequent U/S this time. (I only had one with my last pg.)

Mama to 4 darlings. A ('03), O and K ('06), A ('09), and wife to M since 2002.
mamajody is offline  
#13 of 28 Old 05-17-2006, 07:24 PM
 
LoisLane's Avatar
 
Join Date: Mar 2004
Location: Once again, on the road
Posts: 735
Mentioned: 0 Post(s)
Tagged: 0 Thread(s)
Quoted: 0 Post(s)
HI Natalyla,

Do you know whether your twins are in one placenta or two? If they are sharing a placenta (monochorionic), then they could be at risk for Twin to Twin Transfusion Syndrome, which can happen quickly and often ends with the loss of at least one twin. The regular ultrasounds allow the docs to check their progress and make sure one doesnt' suddenly start growing much quicker than the other. If they catch it, there are a few things that can be done to help the babes, and in a worst case scenario (but not as bad as the loss of one or both), they could do an early delivery.

That was the case with our girls (monochorionic/diamniotic) and, after doing research, my DH and I felt the true risk of TTTS warranted the frequent U/S (every three weeks in our case from discovery to 32 weeks, then every two weeks). I just spoke with a woman at our local twin club whose babes had TTTS -- it was terrifying, but they did catch it in time and were able to save both twins.

Just my 2cents. Good luck with your pregnancy and congrats on your babes!
LoisLane is offline  
#14 of 28 Old 05-17-2006, 09:32 PM
 
redwolf2's Avatar
 
Join Date: Jan 2006
Location: anxiously awaiting autumn
Posts: 676
Mentioned: 0 Post(s)
Tagged: 0 Thread(s)
Quoted: 0 Post(s)
Yes, the TTTS is one reason for having u/s. But twins can carry an extra risk for preterm labor, which is something they will watch for as well. They caught somethings with my u/s that they didn't see the first few times. I did what they asked mainly because it was the only OB I could find to VBAC twins and I wanted to give an inch to get an inch. (I wanted a HB but my midwife was too far for twins, long story)
Your first u/s is probably a level II and does take awhile. They check blood circulation in the babes and in the cords. And they do extensive measuring to rule out TTTS. yes, you have the right to refuse, but weigh out your options.

good luck

namaste
redwolf2 is offline  
#15 of 28 Old 05-17-2006, 11:35 PM - Thread Starter
 
Twice as nice's Avatar
 
Join Date: Feb 2006
Location: Sunny Florida
Posts: 762
Mentioned: 0 Post(s)
Tagged: 0 Thread(s)
Quoted: 0 Post(s)
Quote:
Originally Posted by LoisLane

Do you know whether your twins are in one placenta or two?
My munchkins are completely separate (placentas and sacs)... I guess thats why I dont see the need for an u/s every 4 wks.. from everything I've read, the fact that they are separate seems to eliminate most of the problems that occur in twin pregnancies.

I have an appt with my OB tomorrow and will talk to him see how he responds. I'll try talking to my peri and see if maybe he'll be willing to at least space them out a bit more (maybe 6 wks). Thanks for all of your input, and Royaloakmi, I love the idea of just being a procrastinator about scheduling appts... may end up doing that if nothing else works (wont have to try very hard.. i'm great at procrastinating )
Twice as nice is offline  
#16 of 28 Old 05-18-2006, 12:53 PM
 
emblmrgrl's Avatar
 
Join Date: Jul 2004
Location: Negativeland
Posts: 287
Mentioned: 0 Post(s)
Tagged: 0 Thread(s)
Quoted: 0 Post(s)
I agree the schedule sounds common. Mine were every 4 wks after 20 wks. It did prove to be beneficial for me as my twin B had low amniotic fluid @ 36 wks and I was induced. However, if I wasn't comfortable with it, I'd at least ask to space them out more or go the procrastination route. Good luck!
emblmrgrl is offline  
#17 of 28 Old 05-18-2006, 08:23 PM
 
eden/averymum's Avatar
 
Join Date: Jun 2005
Location: Canada Baby, here comes the snow!
Posts: 1,596
Mentioned: 0 Post(s)
Tagged: 0 Thread(s)
Quoted: 0 Post(s)
every four weeks is pretty normal from what I hear on my twins board. More often actually, weekely or biweekly at least if they share a placenta is recomended by the twin to twin transfusion syndrome organization. I had 2-3 weekly after 24 weeks because my girls were monoamniotic
eden/averymum is offline  
#18 of 28 Old 05-20-2006, 11:44 PM
 
sarahloughmiller's Avatar
 
Join Date: May 2004
Posts: 1,100
Mentioned: 0 Post(s)
Tagged: 0 Thread(s)
Quoted: 0 Post(s)
every 4 weeks seems to be the norm, but you can refuse. I would talk to the doc at the 1st appt and tell him how many you feel comfortable with and see if you can compromise on something. Or if you just want the 1 keep canceling and not rescheduling, they may not even notice!
sarahloughmiller is offline  
#19 of 28 Old 05-22-2006, 10:15 PM
 
Azreial's Avatar
 
Join Date: Jul 2004
Location: Gloucester MA
Posts: 2,389
Mentioned: 0 Post(s)
Tagged: 0 Thread(s)
Quoted: 0 Post(s)
My bc mw's told me every 4weeks until 30some-odd weeks and then every 2 weeks until 36 or 38wks and then weekly. Pretty much for the reasons already given. However last u/s one was much smaller than the other so I had to schedule another in 2wks instead of 4. Depending on how that goes I'll either be every 2 wks or back to every 4wks

But if you really don't want to do that many I definatly reccomend having a lot of "scheduling conflicts"

mum to Christopher (6/98) Elizabeth (2/05) twins Aaron and Dominic (7/10/06) and new baby Eden (4-18-09)
Azreial is offline  
#20 of 28 Old 05-23-2006, 11:20 PM
 
tikva18's Avatar
 
Join Date: Dec 2005
Location: midwest
Posts: 1,908
Mentioned: 0 Post(s)
Tagged: 0 Thread(s)
Quoted: 0 Post(s)
It sounds like a level 2 ultrasound which did take a long time for me, but it did not last the whole two hours.

As much as I did not want to have so many ultrasounds, I also did not want to rock the boat with my dr. too much so I was compliant. It was nice to be able to peak in on my babies.

Rivka, mommy to 3 big boys and a set of b/g twins
tikva18 is offline  
#21 of 28 Old 05-24-2006, 05:49 PM
 
mamajody's Avatar
 
Join Date: Jul 2004
Location: New Britain, CT
Posts: 1,704
Mentioned: 0 Post(s)
Tagged: 0 Thread(s)
Quoted: 0 Post(s)
I had my level 2 today, and it took about 1 1/2hrs. Not too bad considering they have the tech and the maternal/fetal specialist both look seperately at each babe. The doc. was also really up front with everything she was looking at and why. Sooooo different from the office tech that does the routine u/s. Anyway i thought it was great to see the little hearts beating and hear the doc say, "now isn't that the coolest thing. i could look at little hearts all day!"

They ran down the schedule for diagnostics with me for the rest of the pregnancy:

Every 4 weeks an u/s until 32 weeks.
At 32 weeks I begin NST's TWICE a week until birth with u/s as needed to determine cervical readiness and/or position in the event I need to deliver early. I am pleasantly surprised. That isn't much more than I had with DD when i tested positive for gestational diabetes.

Mama to 4 darlings. A ('03), O and K ('06), A ('09), and wife to M since 2002.
mamajody is offline  
#22 of 28 Old 06-03-2006, 10:20 PM
 
mamajody's Avatar
 
Join Date: Jul 2004
Location: New Britain, CT
Posts: 1,704
Mentioned: 0 Post(s)
Tagged: 0 Thread(s)
Quoted: 0 Post(s)
I had my 20week visit yesterday. I was ok with the Peri.'s plan to u/s every four weeks and NST after 32 weeks, but now my OB is telling me I will have to have quick u/s every visit to the office because they can't get distinct HB's with the doppler. The boys just stick too close together. It only took about a minute to find both heartbeats, but I JUST had a Level 2 u/s lst week! The same thing will happen again in 3 weeks. I will have my next appointment with the peri., and then 5 days later back at the OB. This will probably continue for the duration.:

Mama to 4 darlings. A ('03), O and K ('06), A ('09), and wife to M since 2002.
mamajody is offline  
#23 of 28 Old 06-03-2006, 10:21 PM
 
mamajody's Avatar
 
Join Date: Jul 2004
Location: New Britain, CT
Posts: 1,704
Mentioned: 0 Post(s)
Tagged: 0 Thread(s)
Quoted: 0 Post(s)
Double Post strikes again!

Mama to 4 darlings. A ('03), O and K ('06), A ('09), and wife to M since 2002.
mamajody is offline  
#24 of 28 Old 06-04-2006, 12:58 AM - Thread Starter
 
Twice as nice's Avatar
 
Join Date: Feb 2006
Location: Sunny Florida
Posts: 762
Mentioned: 0 Post(s)
Tagged: 0 Thread(s)
Quoted: 0 Post(s)
I havent seen the perinatologist yet (going in on tuesday), but at my last OB visit (this past friday), the OB used u/s to check heartbeats as well. The other docs i've seen up till now have used dopplers, but this one said that he doesnt trust them because he cant be sure he is listening to two different heartbeats not one (hello.... they have different heart-rates).

I'm going to talk to the OB about it next time I go in... if the Peri is already doing these u/s every 4-6 weeks and the OB gets his reports, what is the point of doing additional u/s just to get a heartrate... cant they get that from the Peri's report? (sorry, i'm a bit frustrated at all of these unnecessary procedures)
Twice as nice is offline  
#25 of 28 Old 06-04-2006, 01:26 AM
 
alegna's Avatar
 
Join Date: Jan 2003
Posts: 44,408
Mentioned: 0 Post(s)
Tagged: 0 Thread(s)
Quoted: 0 Post(s)
Quote:
Originally Posted by mamajody
I had my 20week visit yesterday. I was ok with the Peri.'s plan to u/s every four weeks and NST after 32 weeks, but now my OB is telling me I will have to have quick u/s every visit to the office because they can't get distinct HB's with the doppler. The boys just stick too close together. It only took about a minute to find both heartbeats, but I JUST had a Level 2 u/s lst week! The same thing will happen again in 3 weeks. I will have my next appointment with the peri., and then 5 days later back at the OB. This will probably continue for the duration.:
If it bugs you, just say no. There's no pressing reason to check the heartbeats every time that closely.

-Angela
alegna is offline  
#26 of 28 Old 06-04-2006, 03:06 AM
 
1growingsprout's Avatar
 
Join Date: Nov 2005
Posts: 2,791
Mentioned: 0 Post(s)
Tagged: 0 Thread(s)
Quoted: 0 Post(s)
fwiw im approx 7 mos pgnt w. twins... im still with my regular OB... i only had US after ob was adamant... dh and i thought baby was sick or something... it took about 10 mins... just to confirm the twins... my dr is great and knows i dont like US... no particular reason...i just dont like them ... we dont know the sex... i want to be surprised... and let me tell you getting pgnt 1 month after having dd was a surprise then to find out twins... sheezez

i will most probably end up delivering early as these are bio kids 4&5.... so i could technically have 3 kids in 9 months... ages 9 mos and newborns...

good luck and congrats on the babes...
1growingsprout is offline  
#27 of 28 Old 06-06-2006, 10:45 AM
 
tikva18's Avatar
 
Join Date: Dec 2005
Location: midwest
Posts: 1,908
Mentioned: 0 Post(s)
Tagged: 0 Thread(s)
Quoted: 0 Post(s)
1growingsprout, may you have the strength you need to make it to the end of your pregnancy! My twins also were numbers 4 and 5 - they were evicted at 35w5d because the dr.s decided taht twin a was no longer growing. Happy to say that we are at the 9 month mark!

Rivka, mommy to 3 big boys and a set of b/g twins
tikva18 is offline  
#28 of 28 Old 06-06-2006, 11:21 AM
 
Kajira's Avatar
 
Join Date: May 2006
Posts: 1,647
Mentioned: 0 Post(s)
Tagged: 0 Thread(s)
Quoted: 0 Post(s)
Just going on what you've said I would stick with them, yes u/s are a pain, but from what I've read on other boards with moms of twins they aren't asking for a crazy amount , I've seen women sent for u/s every week from 18 weeks, also they seem to be slow in throwing the high risk blanket up, if they are slow at risking you out I say work with them
Plan appointments back to back, with the peri first so that he can make a copy of any info and you take it to the ob and you only need one u/s etc

You are seeing a peri who due to the nature of the pratice will deal strictly with high risk and has a standard of care which leads to being more cautious, which is why he may request more u/s, they trust what they can see.


While I respect Alegna's view, there are risk with multiples that we moms of singletons have never dealt with, and in my view until you have a full idea if they are sharing a placenta or have any other risk it's not worth it to fight them as yet, there will be plenty fighting in the months to come.

As for u/s to check heart beat that is standard in multiples.
Kajira is offline  
Reply

Quick Reply
Message:
Drag and Drop File Upload
Drag files here to attach!
Upload Progress: 0
Options

Register Now

In order to be able to post messages on the Mothering Forums forums, you must first register.
Please enter your desired user name, your email address and other required details in the form below.
User Name:
If you do not want to register, fill this field only and the name will be used as user name for your post.
Password
Please enter a password for your user account. Note that passwords are case-sensitive.
Password:
Confirm Password:
Email Address
Please enter a valid email address for yourself.
Email Address:

Log-in

Human Verification

In order to verify that you are a human and not a spam bot, please enter the answer into the following box below based on the instructions contained in the graphic.



User Tag List

Thread Tools
Show Printable Version Show Printable Version
Email this Page Email this Page


Forum Jump: 

Posting Rules  
You may post new threads
You may post replies
You may not post attachments
You may not edit your posts

BB code is On
Smilies are On
[IMG] code is On
HTML code is Off
Trackbacks are On
Pingbacks are On
Refbacks are Off