Consult with the High-Risk OB

Last week I had an appointment with the high-risk OB. My regular OB practice sent me for a consult. Originally, my OB told me that he felt comfortable taking care of my pregnancy, unless anything unusual happened, at which point he would refer me to the local high-risk OB. But then, the message got mixed up. You see, my OB works as part of a larger practice, and despite my attempts to see only my doctor, I managed to see three different doctors and a nurse practitioner over the course of my first few months. And each of those practitioners had their own opinions about the best strategy for a healthy Type 1 pregnancy.  It was confusing at best.

As a result of all of this confusion, I ended up at the high-risk office for a consultation. The high risk OB works alone, without partners. There are obvious advantages to this set up, but also disadvantages. For example, when we went for my consultation, the doctor was delayed because a C-section he was scheduled to perform was bumped from the OR. When there is only one doctor in the practice, there is no partner to share the load. On the plus side, there are fewer conflicting opinions and more consistency. But there are fewer ideas and fewer minds working on my “problem.”  There just isn’t an easy answer, is there?

At the appointment, he was practically dumbfounded by my record A1C (5.3 — Yay!!!), but he did pour over my BGs and suggest a few tweaks to my basal rates. I liked that he seemed open to my opinions, and to  a  more collaborative approach to managing my sugars. He said that I probably know more than him about the disease given my 27 years of living with it. He might be right, but it sure is nice to have a professional opinion every now and then!

On the down side, it seems that he wants to manage my endocrine issues throughout the pregnancy. This is not necessarily a bad thing. Afterall, he did make good suggestions. But I am just now getting this relationship with my Endo worked out. And he does have my A1C down to record lows. I hate to abandon that relationship.

My OB from the regular practice called the next day to say he thinks that the high-risk OB should manage my entire pregnancy. He feels that I would get the best care that way. I can still have some of my run-of-the-mill appointments at my regular OB’s office so that I don’t have to spend so much time on the road (the high-risk OB is in a neighboring, larger city), but the high-risk guy will be in charge and he will deliver my baby.

But there is this nagging feeling in the back of my mind that maybe this is not the best solution. Sigh. I don’t know what to do. I just don’t want to screw this up. My baby is depending on me.

I have an appointment with my Endo in early January, so I expect to ask him  for his advice. I think he may be a bit miffed that he is sort of  being forced out of the equation by the high-risk guy. But maybe my Endo knows another high-risk guy who works more closely with the Endo. As a third alternative, I asked my mom to ask her Endo for advice. Her Endo recommends a hospital system in another surrounding city, but it is even further away from home. However, that hospital seems to be “the place” for pregnant diabetics in the area. And it has had that status for quite some time. In fact, it is the same place that my mom delivered me 31 years ago.

So what should have been a settling appointment has left me with new questions and few answers. Maybe I just need to relax a little and go with the flow? What would you do?

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