A Tale of Two Obstetricians (10w6d)

Once I got past the sheer enormity of the place (thank you, BPF for going with me!) and saw the visual reassurance of Live Baby, I have to say I felt very comfortable at the perinatologist appointment earlier this week.  It's a place where things are expected to go wrong, they know how to deal with the unexpected, and a woman on Lovenox,with a history of RPL who did a DE cycle is not out of the norm.  So how, the doctor asked, did Dr. Gorgeous get you pregnant?  As I said the other day, he wasn't particularly alarmist but he also took me, and this condition, quite seriously.

Then I met my OB, whom, as I said, I really do like.  An OB who used to be an English major?  An OB who is all for VBAC and natural childbirth?  An OB who makes jokes and talks about her own family?  All good, as far as I'm concerned.  And if I'd met her in a different life, before I'd had a miscarriage, before I'd been through a high-risk pregnancy and all the rigamarole that entails, I would have been very, very happy coming out of that appointment.  But to be told that APA doesn't tend to cause third trimester problems and therefore doesn't require monitoring?  To be told that this GS issue will just "go away" after twelve weeks?  Well, from what I know, from what I've read, from what other doctors have told me, that's just wrong.  Clearly, APA can cause problems later in pregnancy or there would be no reason to keep me on Lovenox the whole damn time (which she is, at least until 36 weeks when I get switched over to regular old heparin).  Basically, if there's a pregnancy complication, APA makes you much more likely to have it (IUGR and placental problems, low amniotic fluid (hello?!), eclampsia, stroke, blah blah blah).  And according to Dr. Gorgeous, as well as me reading crap on the internet, oligohydramnios (the technical name for low amniotic fluid, which is what this sac problem is) is a HUGE deal for potential problems down the road.

Now I don't want to be the crazy, paranoid patient.  I really wish I could be blase about all this.  I really wish I could just gain weight (check), feel this baby move (check), and show up for montly appointments and go about my business like a normal pregnant woman.  But I'm not.  I've had two losses, at least one likely chemical pregnancy, the now confirmed loss of a twin, and several years of fertility treatment to get here.  To say this baby is wanted is a radical understatement.

So I'm not sure what to do.  My next app't is in two weeks, for the nuchal translucency.  That happens to fall during the window of checking out the baby's urinary system, which the perinatologist recommended.  Right now I'm scheduled to do both of those locally, with the OB.  I'm thinking I'll see if I can see the perinatologist instead.  It adds abut 2.5 hours in the car, but I'd really like a better sense of prognosis here.  I just don't believe that after all this, all the fear, all the threat, vanishes after the first trimester.  By all accounts, I shouldn't even have made it this far.

In the meantime, I got a message late on Thursday from Nurse of the Everchanging Nickname, saying Dr. G wanted the update.  I'm waiting for her to call/email me back, but I have a feeling she'll like this tag-team OB/peri idea for me.  I think she knows better than anyone what I really need to get me through this experience more or less in one piece.