No heartbeat on doppler at 11wk5d (???)

Just had my first official prenatal appt at 11wk5days. Couldn’t find the heartbeat on doppler, but the Dr. said he wasn’t worried, he says my abdominal wall thickness makes it tricky (haha, aka my masters belly from too little exercise these past six months!!!) and as I’ve had no cramping, no bleeding and my 8 week quantitative hcg was ‘good’. I asked him what ‘good’ meant; he said around 6000. I am thinking if it was 6000 at 8 weeks, I should have miscarried by now as it should have been SIXTY thousand, not six thousand at that stage. GAH. I glanced at the page, I think I saw 60 096 or something like that so maybe he just read the number wrong aloud?

I really don’t trust my doctor. He sent me for the maternal serum screen at 8 weeks- this can only be done between 15 to 17 weeks or you get results that are not interpretable. He should have sent me for the prenatal panel, which gets your antigen/antibody status for HIV, Hep B, Rubella etc. established. Today, he offered to send me for a repeat quantitative bHCG ‘for peace of mind’. Of course he didn’t realize that the form had a check box for this, and instead illegibly wrote it by hand where the lab tech thought I needed a urine pee test for qualitative, not quantitative analysis. That straightened out, the tech finally says it will be drawn now but likely not processed until Monday as the doctor didn’t write STAT on the form. I joked and said I work in healthcare, let me put STAT on it for you. Anyways, I told the tech he asked me to call his office this aft to get the result, (which he did, he said he’d forget to call so could I call him instead) to see if I was going to miscarry, and she said she’d call him to clarify the form. Now, what kind of family medicine does this guy practice if a) he doesn’t know when to time maternal testing b)he quotes incorrect and/or dangerously low hcg levels as ‘good’ c)he isn’t worried about no doppler heart at 11+5d but I don’t trust his ‘worry instinct’ so what is that worth anyways? and d) he didn’t even have a pregnancy wheel in his office, just asked me how far along I was today. SHEESH.

Oh yeah, at my 8 week appt he said he’d book an ultrasound to see if the pregnancy was progressing well, since we had a previous early pregnancy loss in May. What do you know, he books one for November 25th, when I’ll be be 21 weeks. First of all, that’s not a first trimester ultrasound buddy. Second of all, the guidelines suggest 16 – 20 weeks for the second trimester ultrasound anyways. Why are you sending me at one week past the guideline? Why add any additional issues to the suggested timeframes? I feel no trust in this guy’s ability for care, but as I’m new to Winnipeg I have little choice of practitioners to see. There are three family doctors taking new patients, and the other two had a 6 week wait to get appointments.

The only solace I can hope is that my OB appt (Oct 13th) goes more smoothly than the two disorganized visits this guy has demonstrated. At least he is my referral gate at this point.

It is really frustrating when you know how things SHOULD be done in terms of liability, quality of care, professionalism in primary care and then you’re left to self advocate to get what was already negotiated as being in process from your previous appointment. No wonder it takes so long to get things completed! Also, they did the hcg draw today, but as he didn’t put in the prenatal panel when I clarified why there were missing results, I will have to get another blood draw to rule that out in the future. So disorganized! What a waste of resources (mine and the taxpayers).

*sigh* End rant. Sort of.

Luckily, even if the hcg results don’t tell us much (and above 6000, most hcg testing is moot due to variations in hcg levels and plateau/fall once the placenta is doing more hormone production, hence why he thinks an 11+5d hcg is going to give any peace of mind beyond ruling out the catastrophic is ridiculous, let alone that it might not even be processed until monday) I got the number for the regional ultrasound clinic from his secretary, who is equally frustrated with his ineptitude I’m sure. I have my nuchal translucency u/s scheduled for October 7th (a test which, while not totally necessary is one I am self advocating for due to my ‘elderly primigravida’ status). We also have a babymoon appt, which is a private clinic in Winnipeg that offers a look at the heartbeat for $20 on October 2nd. I think I won’t relax until I see that there actually is a baby in there to account for my 5lb weight gain so far. My friend Nikki said it best, miscarriage steals your innocence. I definitely have to self talk myself away from doubting this baby.

And there’s always the whole philosophical argument that before viability of a fetus, all this testing does is give information, not hope of changing outcome, so really I should just let nature take its course. But the fear of repeating the past, the pain of loss of dreams and hopes in a pregnancy makes these little snafus all the more irritating and ingratiating. It doesn’t help when things don’t ‘go as planned’, I suppose.

*sigh* The babe isn’t even here yet and already I’m a nervous Momma. I texted the situation to Jack: "I are not worried either- I love you!" I think he’s convinced he made a good baby that won’t leave before it should ;0)

FGirl