Post Op Appt Update

My ob is giving me the out of network referral for Dr. H. I asked him if he knew about him. He said yes, he has referred several patients with endometriosis to him. HELLO WHAT ABOUT ME???? I said well he is out of network and I need an out of network referral. He said well how are you going to pay for it, cash? I said umm no, that is why I am asking for an out of network referral. He said ok and gave me a rx for an out of network referral. I said what do I do with this???? He looked at me confused (he must have delivered too many babies this week!). I said I think YOU have to coordinate it with the insurance company. Then he kicked into gear and said he would coordinate it with his billing person. She does all his disability paperwork, billing, and stuff. I thought I hope the billing person knows how to do this. I said I would go in network but I scrubbed the entire area and there is no one else but regular obgyns. I told him that he had talked about a general surgeon but I didn’t want a general surgeon cause they like to CUT you. He laughed and agreed. He said that there is no one else. That this is where I needed to go and he would work it out with the billing person. I asked him how would I know if it had gone through, he said that I could call and ask the billing person or the insurance company would send him a letter and carbon copy me on it. He did take down when the appt was and time and said he would work it.

The lower incision looks great. The belly button incision is looking a tiny bit infected. I have been using peroxide and Neosporin religiously. I told him it was still open a bit. Each day it closes a little bit. He said yeah it is still open a bit. Stop using full strength peroxide because it is damaging the tissue. He said that stuff is really strong and to cut it in half with tap water to clean it. He said keep using Neosporin. He said if it gets any worse he wanted me to call and let him look at it again. What would he do for it, put me on an antibiotic?? That would suck.

He asked me about bleeding. I said it was light and spotting after surgery. Stopped on Sunday night, Monday morning after surgery (a week) and then started back up in force on Tuesday morning. He said oh the surgery (anesthesia) threw your cycles off. You are having your period (which made me turn even redder. I hate turning into a tomato!) I figured as much with the excruciating pain it was. I had pain even with Lortab and motrin but at least it was bearable this time with the Lortab.

As far as meds when I ttc. No to motrin, I have to switch to Tylenol (will that even work???), start baby aspirin after I see him for a positive pregnancy test to prevent pe, and yes Gluconsamine and chondroitin are ok to take.

He went ahead and wrote orders for a 24hr urine and Preeclampsia labs as a baseline. I told him I had clotting bloodwork done in January and he said he had a copy of that (they copy all the drs here on that stuff. He said HIPPA makes it hard to get labwork from the hospital, so they list the obgyn and PCP as primaries on all hospital paperwork). The only thing that was high was protein S but my pcp said it was up because I had just had surgery. Oh and he told I would get a container for a 24 hr urine. I said btdt. I have done many 24 hr urine tests.
A 24 urine test is the only way to know reliably how much protein your body is dumping. Less than 300mg/dl is normal. Anything over 300mg/dl when pregnant is preeclampsia. When I had my oldest, I was dumping 5000mg. My kidneys were not working.

I told him I had counted out my loestrin and that I didn’t have enough to get to November 1st and that I needed one more. He gave me a sample of it. So now I have enough. No turning back on that seeing he didn’t write a rx.

I asked him about the prometrium. Did I need to stop it when I stopped the loestrin. He said yes. He said that it’s not that my body is low in it, it’s that I needed an extra kick to stop breakthrough bleeding. He said that my body should make enough prometrium for pregnancy.

I told him Dr. L would be switching me to Aldomet in September. He said good and he remembered discussing that.

So keep your fingers crossed that he can get the referral through (I lost a little faith with how he was a little off kilter above). I also contacted my pcp’s office and said he was giving it to me and working with me on it. But I worried he wouldn’t get it through. They said if he can’t we will.

Oh and he said it was ok to still try in Nov even though I am seeing this specialist in Oct. He said there wasn’t anything wrong with that at all. I said well at least I would have the consultation done. He agreed. I told him that I didn’t think that there was anything more that he could and he agreed and said I needed to see this dr. He said that he would coordinate care, send post op reports and records to him. I will have the pelvic pain and endo stuff dealt with by the specialist and (OBGYN) would handle everything else. He is ok with that. He said my insurance company wouldn’t pay for like regular annual exams and stuff with the specialist. So I feel a bit better. I just hope that my insurance gives me the out of network authorization and then the referral. Please let these people in his office NOT be idiots. The billing clerk and I had a run in a couple of years ago. So I have to be nice to her to have her help me. She does very well with flattery….

I also called and checked with my insurance company and the rep said it most likely will be approved. They may need to get more info but they would work with my obgyn on that. They said my primary can help with that too. My copay would be $15 for the visit, $15 for outpatient surgery, nothing for inpatient.

Oh and I made my lovely annual exam for 2/15/08. Hope to skip that and be pregnant. If I got pregnant in November, I would have to get it earlier. UGGGGGH. I detest them. Maybe he’ll let me skip if I am pregnant. I doubt it. I had to have one at nine weeks with S. They wait till you are 9-12 weeks preggo for an internal/annual exam.

So please pray that everything falls into place. Pray that I get pregnant in November. Pray that there will a magical solution in October for this pelvic pain. Pray for as little pain as possible. Pray that I make it full term. Pray for a healthy baby. I would like a boy to be different, but at this point, all I care is having a healthy baby. That is how I know that I REALLY want another.