trouble getting appt high risk pregnancy

[Baby3149]

I had a + hpt at 4 weeks and went to a clinic to have it confirmed. At 5 weeks the nurse who did the ultrasound (abdominal) said she just saw an empty sac- no embryo, no heartbeat. The Dr confirmed it was probably an ectopic or chemical pregnancy, and to wait for a miscarriage. When I should have been 12 weeks, I went to an ob/gyn because I still wasn't getting my period and hadn't had a miscarriage. She did an exam and told me she measured my uterus at 5 weeks and to get an u/s to confirm so she could do a d&c. I was depressed about losing the baby, and my son was getting sick alot, I was missing time from work to bring him to the Dr 4 times in Nov and had rent to pay, and I didn't get the u/s for another 2 weeks. (I know, I procrastinated, but I was told twice the embryo was dead). At that u/s I saw my now fetus kicking around, and he/she measured perfectly at 14 weeks.  I'm high risk due to my age (37) and because I've had juvenile diabetes since I was 16. I was referred to the Dr that delivered my other 2 kids as that is the ONLY place my insurance accepts for high-risk pregnancies for type 1 diabetes. Even though the other ob had messed up by measuring my uterus wrong (the u/s tech said no way was I measuring at 5 weeks, as a couple weeks later I was measuring at just over 14 weeks) the earliest appt I could get is for when I will be 18 weeks 3 days along. I live in AZ where there are a lot of pregnant women with diabetes (type 2 is very prevelant in hispanics) who come from Mexico for free medical care.  A LOT.  Now I have to wait this long for an appt. Another month?  Not counting all the time I missed after being told my fetus was DEAD by a nurse, then the Dr she works for, a nurse practitioner, and an ob/gyn?  Does anyone know of any way I can convince them I just can't wait that long?  This Drs office is in a hospital and only sees high risk diabetics one day each week, and they already double book. The wait is usually over an hour after the appt time.

[chiromom]

You didn't tell her to "stretch the truth."  You told her to lie.  You told her to tell the Doctor she was experiencing symptoms that she didn't have.  What if that led the Doctor to do tests that were unnecessary or unwarranted based on those symptoms?  Cramps are much different than diabetes and require much different tests.  I don't care what kind of argument you make - you should never - ever- lie about symptoms.  You even prefaced it by saying, "I know this is a horrible thing to say."  Absolutely nothing positive will come out of lying or making up symptoms that don't exist.  Nothing.

[guatmommy]

I don't look at it as lying.  She has some serious issues that need to addresses AND if there are "other" patients that have issues I am sure they would not postpone them to "fit" her in.  I would do ANYTHING for the welfare of my child/unborn child and if it meant stretching the truth to get an sappt- the cold hard truth is I would do it!

[chiromom]

guatmommy suggested that you lie.  I never said you didn't have issues that shouldn't be addressed.  I said you shouldn't lie.  If you told your concerns to your doctors office, and they didn't think it was urgent, then there really is nothing you can do but call your HR department or the insurance company and tell them your concerns.  I'm just saying I don't agree with lying.
I'm also not saying YOU should go to Mexico for your health care.  I'm saying that I don't understand how they are coming here for health care, when it is not free in the US.  I understand certain ERs, but a private doctors office?  They don't have to take people that don't have insurance.  We have plenty of illegal immigrants here in NY.  They pay cold hard cash to go to a doctor, or go to clinics for people without insurance.  If you are unhappy with your care, don't your waste time here explaining how you deserve better care.  The squeaky wheel gets the grease.  Start squeaking to the people that can help you.  If you believe your doctor is not giving you the care you need, call your insurance company and tell them your concerns.  You are their client.

[Baby3149]

Oh, and I forgot to mention, they offer excellent care, (again, once I can actually be seen for the 1st time for this pregnancy)  They helped me give birth to a beautiful and healthy son and daughter with no health issues, who were both born on time (not early which is a risk with diabetics) and perfect, and as I said in a previous post, there are plenty of other ob/gyns who take my insurance, and see pregnant diabetics, but none see pregnant type 1 diabetics. I actually had to get referred out of network for this, and my insurance pays because no others in network can take type 1 diabetics. Only gestational or type 2 diabetics. So this is the one and only place they can refer me to, as one dr in the group will accept my insurance with a referral.  

[Baby3149]

I'm saying not only do they cause overcrowding in the ERs, they cause overcrowding in drs offices too.  Sorry about the cold hard facts, but that's the way it is.  I'm American, I shouldn't have to go to Canada or Mexico for health care, and we pay for our family's insurance, quite a bit each month, and that simply doesn't leave money to pay out of pocket in addition to insurance. That's why we have insurance. This Dr wants me in once a week for the entire pregnancy, with my other 2 starting at week 4 and week 6, twice a week after 6 months, and 3 times a week for the last 3 weeks - that's the way it was for my other 2 pregnancies, and once I actually get in, the way it will be for this one, which is why I am so surprised I have to wait until I'm 18 1/2 weeks for an appt. I've always gotten early prenatal care, and would have with this one too if I wasn't told my embryo was dead. Time was wasted while I followed instructions and waited for a miscarriage. It's not like I just chose to not seek care until I was 18 weeks along.  If I need to be seen every week, why can't I be seen sooner. I need to be monitored even more closely than someone with type 2 diabetes because I make no insulin whatsoever, and because pregnancy causes my blood sugar to fluctuate alot, and because I have had diabetes so long, I no longer have symptoms before I get hypoglycemia, which can kill me quickly or cause me to go into a coma. (I've had extremely low blood sugar 7 times in the first trimester, not knowing I was still pregnant, so not lowering the amount of insulin I was taking.) People with gestational or type 2 diabetes don't usually have that side effect - they usually feel low blood sugar before it drops to 26.  Is this not a serious issue?  It's not like they would tell someone in labor or who was bleeding they have to wait because I need to be seen. I'm saying it's annoying to have to wait so long because so many people like going to the only place my insurance will pay for because it's in a hospital and hospitals can't turn anyone away. Drs offices can refer elsewhere, like to the free clinics, when patients lack a means to pay or insurance they accept. The Drs I see can't. They have to see everybody that walks in the door whether they plan on paying or not.

[chiromom]

If you are not happy with your care, look up other doctors that take high risk patients.  If they don't take your insurance, pay out of pocket.  If you can't afford that, then you have to go with the system.  We do not have universal health care here in the US.  Health insurance is a business and they do not have to give you anything.  Sorry about the cold hard facts - but that's the way it is.  I do not agree with guatmommy about lying about your symptoms.  What if by squeezing you in, they postpone a patient that has serious issues?  Wouldn't you feel terrible?  I would.  I don't get it.  Americans go to Canada for healthcare when they can't afford it in the US.  Are you saying Mexicans are getting free healthcare they don't deserve?  Write your congressman.

[Baby3149]

Hmmm.  I didn't think of that!  I also don't want to wait because I really want to ask another Dr how I was measured at 5 weeks and no heartbeat was heard, and 2 weeks later I was measuring at (according to the u/s) 14 weeks?  With my other 2 from what I remember can't they tell by how many centimeters or something how far along I was? Or is that only later in the pregnancy? I can't remember but I'm really curious about how she came up with 5 weeks.  I didn't trust the first clinic (the nurse needed the receptionist to show her how to do an u/s) but I certainly trusted my Drs nurse practitioner...

[guatmommy]

This is a horrible thing to say BUT call and say you have bad cramps- chances are they will "fit you in" right away.

[Baby3149]

I have called other Drs that supposedly take high-risk patients, but they all say I need to go to this one place. I don't know why. I thought insurance had to offer a choice, but even the ob/gyns that take high risk patients are telling me the same thing. If I had gestational diabetes, or type 2, I could go to other places, but not with type 1 (juvenile diabetes). And yes, the heartbeat was great. I forgot to mention, the nurse practitioner at my ob/gyns office did a doppler and didn't hear a heartbeat (at 12 weeks?). I think she may have expected me to measure 5 weeks, so that's what she felt, and expected not to hear a heartbeat, so maybe didn't try to hard?  And no, the stress doesn't help, but it's better now that I know he/she is still alive. It was taking its toll when I thought he/she had died, and I was having low blood sugar a lot, because I was taking the same amount of insulin, and eating the same, even though for me, in early pregnancy, I tend to get low blood sugar if I don't temporarily lower the amount of insulin I take, and was having hypoglycemia several times a week, once with my blood sugar dropping to 26 (normal is 70-120). I tried complaining, but was just reminded everyone with an appt that day is diabetic, not just me.  And thank you both for your comments.

[2wonderfulboys]

I would tell them that after all  you have been through and with that dumb nurse scaring you to death, it's the least they could do.. All of this stress isn't good for you either, tell them that!  Just throw a good old fashioned fit! hahaha,,, I wish you the best, and just pray about it too!

[stephie4]

call other periantologists and ask if they take your insurance....
congrats on the kicking fetus, i'm assuming it had a good heartbeat too?