OB appointment & issues...

Okay, so the other day (WED) I had my 25 week appointment. My normally OB was gone for a few days so I saw the nurse practioner instead. I live on a very large island with only 1 public hospital & only 2 OB's... then the nurse practioner that works 1 day a week. I had her once with Zander & LOVED her... plus 4 days a week she works a few hours away at one of the larger hospitals in western washington... so she deals with a lot more twin pregnacnies.

Anyways, at my 23 week appointment (1st since the ultrasound) we went over all the basics with my OB. She is an AWESOME OB, but lacks that 'motherly' bedside manor that some people need... this has never bothered me because if you have a question you just ask & she will answer it. WELL we knew that the girls had seperate amniotic sacs... the ultrasound tech had told us that... so I asked the doctor about the placentas... that was my big concern. Well she said that they had their OWN & that everything had looked good... at 20w2d they were 305g & 307g. Of course my prego brain forgot to ask about the outer chrionic sac (I think thats what its called, I know it starts with a c!). And since she hadn't said they were ID we figured that there were 75%/25% chance of frat or ID.

SO 2 weeks later at my 25 week appointment I asked the nurse practioner... she started reading the chart & said one chrionic sac... one placenta... 2 amniotic sacs. I told her that we were told 2 weeks ago they had their OWN so she double checked... said nope, it says ONE here. & since we had no complications & the OB said they had their own she wasn't gonna send us in for an ultrasound until after my 27 week appointment.

Well Lisa (the NP or PA) wanted to get me in ASAP for an ultrasound cause one placenta presents more risks... even if it is 2 fused. The crappy thing is that it is such a small & busy office they have to send me to the hospital to have a growth ultrasound... & our hospital only has 1 ultrasound machine!!!!! SOOO getting an appointment for a twin growth ultrasound takes 2 WEEKS!!!

Lisa said the OB may have skimmed it to fast & miss read ONE for OWN... or its possible I wasn't paying totally attention when she answered my question... but this really bothers me!!! Lisa said I should have had a 2nd ultrasound at 24 weeks (4weeks later) since its a shared placenta. instead I will be 26w6d!!! Thats almost 7 weeks later!!!! The worst part is that it is 2 hours before my glucose test & appointment!!!! So the OB won't even be able to go over the results with me that day! I would get it scheduled for the next day, but Wed are her c-section day & I would see Lisa again... this would be fine but I want to talk to the OB.

I am not sure what to do. My OB is great BUT she only delivers about 3-5 sets of multiples a year. The problem is because of where we live we don't have choices!!! The other OB is old school & hes been here for a few months (replaced another GREAT & well loved OB) & all I have heard is horr stories! Thats part of the problem... everyone is switching back to my OB & she is getting overloaded. & living on an island the nearest hospital/specialist is a 15 drive... 20-30 minute wait... 20-30 minute $15 ferry boat ride (that STOPS between 12 & 5 AM!!) & another 30 minute drive. Thats almost a 2 hour commute as long as we make the boat. PLUS if you go into labor late at night like I did with my son then I have to go to the local hospital anyways. & To top it off it would be $15 a week for ferry fare ALONE that doesn't include the other $8-$10 in gas!!!! & honestly we can't afford that out of pocket right now.

This is just so over my head & I can't even talk to anyone about it for another week & a half!!!!!!

Well for appoinment stuff... my blood pressure was great, I was measuring 29 weeks (so 4 weeks ahead) & I have gained a total of 17lbs. Heart beats sounded good as well.

SO FAR I have had a very normally pregnacy... the ONLY problem I have had is with a 1"X3" section of muscle of my top right side of my belly... it is about 1" above the top of my uterus... since baby A is laying low & in the middle & baby b is high & almost all to the left the uneven weight distibution is KILLING me. That little spot just HURTS after about 15 minutes of anything & doesn't feel better until I lay down for an hour... & still it goes right back to hurting... this REALLY sucks with a 20 month old running around! Anyways I went to Babies'r'us & got me a belly support LIFESAVER! It made the pain go away almost instantly. I am a shopper... when prego with my son I could still shop all day up until I went into labor! Well the last few weeks I was dying after 30 minutes. Yesterday I was able to make it through BRU, a consignment shop & costco! Only about 3 hours of being on my feet with lots of car time inbetween, but I feel SO much better being able to DO something. I know that in about 5-7 weeks I will really have to slow down, so I want to get it out of my system now.

Sorry it was so long, it has been a very long & emotional rough week!

 

My goodness, how frustrating being told one thing and having it really be another! I am soo sorry to hear the stress you are under in regards to your medical care. I can tell you that we do have members who travel 2 hours each way to get the care they need so please don't rule that out if that is what will make you feel the most confident!

Sounds like over all things are going well. Glad to hear the belly support is helping with the pain!

 

Boy, I can relate to so much of your post!! During my last twin pregnancy I was misdiagnosed as having two placentas. Unfortunately my girls developed TTTS, which was WAY overlooked...it turned out that they DID share a placenta. Anyway, it's important to know one way or the other and if their chorionicity is unknown, it's better to err on the side of caution. This time we know for sure they share a placenta and we have pushed to have the care we feel is necessary. I'm one of those who travels two hours both ways to the peri, but it's definitely worth it. It sounds like your options are somewhat limited but just try to push for the best care possible. Your fundal height sounds good...with TTTS you usually grow very rapidly due to the excess fluid. We're in the same predicament as far as hospitals are concerned. Local hospital 25 minutes away with no NICU, etc., and the nearest one with a NICU is almost 2 hours away!

Wish there was more I could say to help, but just wanted to send you a hug.

That's weird how you've had that pain on your belly, because I have something simiilar to that as well. My uterus shifts to the right side so there's a spot that gets really tender there. I had it with DD too, though, and was told it was a pinched nerve and there's nothing I could do about it. It hasn't been too bad yet, but I think that's because I'm on bed rest. With DD, it felt like I had a really bad sunburn in that one spot but the burning feeling wasn't just on the top layer if that makes sense. Is that what yours is like?

Hope things get a little better for you!

 

Melissa that is very much what it was like!!!! The reason I realized what it was was because I mentioned it to a friend. She had a singleton that was large but like to hang out on one side... her OB said it was basically her muscle slowly & PAINFULLY starting to tearing... because it was being pulled down so hard! When she told my WHY & WHAT I went & got the support... & WALLA! When I asked the NP or PA she had no clue, must be a growing pain

As for the commute... I wouldn't mind the drive so much, but I had a pretty fast labor with my son. That & the ferrys are EXTREMELY a pain in the but... some days you have to wait in line for over an hour just to get to the DOCK!!!!

When it comes to deliver itself I LOVE my local hospital... it only has 4 labor rooms & 2 c-section recovery rooms & you stay in the same room (NOT SHARED) the whole time. Also my hospital has a great 'fly you the **** out of here' policy on emergency's because its only about a 15-20 minute helicopter ride to the other hospital.


Honestly when I heard that first thing that went through my head was your 2 little angels!!!! It just made me want to cry. I am staying optimistic though but going batty as all **** waiting for my ultrasound!

Thanks for the support, I need it right now!

 

I know it's really hard and worrisome to be waiting for your next ultrasound, but I just wanted to say it's great that you've already gotten past 25 weeks with no problems. Do you have any ultrasound pictures from early on? How early did you have your first ultrasound? I've seen different u/s pics from monochorionic twin pregnancies and it seems like even early on you can tell certain things. The pics from my last ultrasound clearly show one chorionic sac and the babies were really 'tight' in there, showing that they most likely shared a lot. But I only know that from comparing to u/s pics of this pregnancy and other people's. My doctor last time was sooooo uneducated or ignorant about twin ultrasounds.

 

I am sorry you are going through all this! What a headache, major frustrations. Yuck.

I know my situation is different than yours, but, I have had problems with getting in to get an ultrasound and had to push my docs too. At my 12-week u/s they couldn't find a membrane and my doc didn't seem at all worried about it. I go to a small hospital and my doc isn't an OB. So, I pushed for a referral to a perinatologist (an hour away) and got a high res u/s. That is where we found out, last Monday, that we do have a membrane but the babies share a placenta and already have TTTS.

I hope you can get something switched around and get that ultrasound earlier. I do think it's good that you have made it this far with no problems!

 

quote:
Originally posted by Raneysmama:
I know it's really hard and worrisome to be waiting for your next ultrasound, but I just wanted to say it's great that you've already gotten past 25 weeks with no problems. Do you have any ultrasound pictures from early on? How early did you have your first ultrasound? I've seen different u/s pics from monochorionic twin pregnancies and it seems like even early on you can tell certain things. The pics from my last ultrasound clearly show one chorionic sac and the babies were really 'tight' in there, showing that they most likely shared a lot. But I only know that from comparing to u/s pics of this pregnancy and other people's. My doctor last time was sooooo uneducated or ignorant about twin ultrasounds.


so far my one & only U/S was at 20w2d... that is when we found out that it is twins. I don't doubt the chart totally... I mean this time the nurse practioner showed it to me & it hadn't been changed or updated since the 2 weeks before.

This is the only U/S pic that I have of them together. The U/S tech had to look REALLY hard to even find the membrane for the amniotic sac.

Baby B & Baby A headshots!


These are the only 2 other pics that they printed out for me...

Baby B

Baby A


I know I am so lucky to have made it to this point without any complications & with out that added worries. I also know it was a great sign that they were 305 & 307 at 20 weeks! I am trying to stay on the positive side of everything... I am a glass half full kinda gal! But all this waiting is gonna kill me, it will be almost 7 weeks since the first & only ultrasound!

 

I can understand your frustration. I don't live to far away from you. We're in Lake Stevens ~ just a couple minutes away from Everett. Could you drive around, instead of taking the ferry? I know gas prices are crazy again...but depending on where you are on Whidbey it might not be too bad. I used to live in Oak Harbor as a kid and we would make it into Everett within and hour to an hour and a half. Just a thought. Try not to worry too much...I KNOW, easier said than done.

April

 

quote:
Originally posted by Aprilisdisney:
I can understand your frustration. I don't live to far away from you. We're in Lake Stevens ~ just a couple minutes away from Everett. Could you drive around, instead of taking the ferry? I know gas prices are crazy again...but depending on where you are on Whidbey it might not be too bad. I used to live in Oak Harbor as a kid and we would make it into Everett within and hour to an hour and a half. Just a thought. Try not to worry too much...I KNOW, easier said than done.

April


I live on the opposite end of the island down in Langley... it takes me about 2.5 hours to drive around in 'good' traffic. On a GOOD part of the day I can get from my house to everett in about 45-60 minutes as long as I don't miss any ferrys & its only about 20 minutes of actual driving. Plus the gas costs more then the ferry.

 

Sorry I just now saw your u/s pics. I thought maybe you'd had an ultrasound eariler on...there's not much I could say about these pics. I can say a hard to find amniotic membrane is very typical of monochorionic twins. Cute pics, by the way. Love the profile one!

 

I love the profile too!! I wish baby A would have stopped being a camera hog... we could have gotten a profile of baby B too!

Yeah so far I have only had the one U/S... but as you can tell you can't see the amniotic membrane in the heads shot... She only got a look at it a few times & it was very hard to see! The chart says they share a Chorionic Sac... even if the placentas fused they would still be ID... All the problems stem from the fact that the OB was in a hurry & misread the chart. All I can say is I am SOOOOOOOO thankful I asked the practioner... otherwise who knows when we would have found out!!! Its just one of those things I guess, I am gonna be having a very long talk with her next week. Well only 8 more days till I get to see them again

Thank god I have a doppler... so I can hear their heartbeats almost anytime I want!!! Sometimes its hard if one of them has flipped around, & they like to kick the doppler just like Zander did & they have darn good aim!

 

I know you must be so anxious, I have had the same worries about TTTS ever since I found out they were most likely identical at 7 weeks. I did want to give you some info that I got last week and found very reassuring. I had my first peri appointment and high resolution u/s with her. She knew I was worried about TTTS and she told me that in the severe cases there are generally always signs by 20 weeks. My girls both measured 13 oz., and looked perfect. It sounds like everything was looking perfect for you at 20 weeks as well. I hope that helps you through the next couple of weeks. I know it's nerve racking.

Jennifer