post-miscarriage experience at GW?
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Anonymous
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Hi. Just looking for some advice and feedback. Saw Dr. Bridges when I had my now-16-month-old, but due to severe postpartum hypertension, needed to switch to a high-risk OB for the second. So I chose Macri at GW based on recs. Got pregnant in November, and my hcgs were low all along (with some spotting); he was very responsive and called me himself with every hcg level. I wound up miscarrying at about 6 weeks. He didn't call to tell me the final test showing my hcg was going down and it was indeed a miscarriage - a nurse called instead. Having a miscarriage was, obviously, very upsetting.
When i saw him at the followup appt a month later, he said if I got pregnant again I should wait a few weeks before calling for testing. I agreed at the time, though I wasn't sure how I felt about it - we just didn't have a long conversation about it. Now I am lucky enough to be pregnant again, just two months later. I feel very fortunate to have a chance again. I found out at home on Saturday, and on Monday I called his office - not to demand testing, but just to touch base about next steps for following HCG. I was starting to feel pretty clearly that I want to know the numbers, because if they're higher than last time I can feel slightly reassured, and if they're very low again, I can manage my expectations better. His assistant scheduled me for an US at 6 weeks 1 day, which surprised me a bit (didn't ask for an early one), but that's cool. That's two weeks from now. She also said she would check with him about ordering the HCGs. I waited all day... no call. The next day I waited... and finally called again midafternoon. She checked and said oh, he hasn't checked that message (??) and said she'd write him again. Waited the rest of the day... no call. Today's Wednesday... no call. I call again early afternoon and she says she's going to go talk to him now and call me back. And... no call. I have been very calm and polite on all these calls. I don't think it's unreasonable for someone who just went through a miscarriage to ask her doctor about doing very basic tests to learn more about how this pregnancy is going. I mean, if he wants to make the case that I should delay testing, he could convey that message to me, instead of just NOT RESPONDING! I am finding that the stress of dealing with them is starting to be even worse than the stress of worrying about another miscarriage. This is not what I need right now. I have a different appt at GW tomorrow and plan to just walk to the offices and see what's up. But I wanted to see if other people have had similar experiences, and what happened. Maybe I was spoiled by the small practice at Bridges (and by Dr. Macri's initial, though brief, period of responsiveness last time). I just expect at least SOME kind of communication and followup. They must know that becoming pregnant again after a miscarriage is a very challenging time. Any thoughts/advice? |
Anonymous
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OP, I am so sorry this is happening and I can imagine how stressed you must be. I am not sure if my response will be helpful, because my experience was a little different, but for what it is worth- Dr. Macri saw me through a very difficult pregnancy with an extended hospital stay and I cannot say enough about the wonderful care I received. He was very responsive, but yes, there were times when things got miscommunicated. I think at GW (and I'm sure tons of people will concur with me) the mixup/holdup is often with the front desk staff. Now, that does not make it better or excusable at all. But I just mention it because I think you will receive first rate care from Dr. Macri if you decide to stay with him. He spent lots of time talking with me, helping me weigh options, letting me voice my fears. And in the midst of all this he was, obviously, helping tons of other patients with high risk pregnancies.
Best of luck OP on whatever you decide. I'm sure you will get lots of good advice here. |
jindc
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I have no advice but I am sorry for your loss and hoping you have a happy, healthy 9 months.
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Anonymous
| You won't like this answer but it's the reality. It's not priority although it feels like it is to you. The outcome of the blood test will not influence your care at all as most OB's won't see you until 8 weeks because there is simply no treatment to prevent a miscarriage. So, in essence, it is an unnecessary test no matter how much you desire it. The only circumstance that it is helpful is IVF where there is an increased risk of ectopic and the lower numbers are followed quite closely as well as follow up ultrasounds. |
Anonymous
| Hi there, I also see Dr Macri for my current pregnancy but met Dr. Bridges for a preconception consultation. I think that the lack of communication could very well be the result of the administrative staff and not Dr. Macri. I have also had frustrating experiences with administrative staff there. Make sure when you do finally see Dr. Macri that you tell him your frustration, including exactly how many times you called over what time period. I also need a high risk doctor, Sibley was not an option since is does not have a full emergency staff, so I was deciding between GW and Georgetown, and the high risk OBs seem to only be hospital-based. As frustrating as GW can be, in my experience it is still better than Georgetown. If you want complete access to your doctor, Dr. Larsen with GW but based in Bethesda gives his cell phone number to his patients. Stay calm and good luck! |
Anonymous
| OP here. Thank you all so much for your feedback. Sounds like it's worth seeing things through with Dr, Macri if I do stay pregnant. I know that doing hcg now wouldn't affect my medical treatment, but my sense is that, with women who have miscarried, it is not unusual to provide them as reassurance (or warning, if they're low). And if they wanted to tell me that they're notall going toto order it, that would be different - radio silence just doesn't seem like a very nice response. |
Anonymous
| I transferred to GW OB from GW IVF and had a hellish experience. They just don't pay much attention during early pregnancy and I got bounced around from doctor to doctor, despite the fact that I had a serious complication requiring frequent ER visits. I never did get to see the doctor who was supposed to be my primary and the doctors who saw me didn't seem remotely educated on either my (admittedly rare) medical problem or my specific case. Getting through to the doctors was also basically impossible and on several occasions their assistants didn't even call me back after I called to report that I'd been to the ER. I ended up losing the pregnancy, which was not something that could have been helped so I don't blame the doctors for that, but I was horrified at the care I got and how poorly my case was managed. Although much less conveniently located, I've gone back to my former doctor at Cap Women's Care. I'm so glad to be getting competent care again. |
Anonymous
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OP, I've had great post-miscarriage experience with the midwives at GW. To be part of their practice you need to be really committed to unmedicated childbirth. If that's your cup of tea, great, and if not, you may want to try out a different OB at GW. I like Dr. Macri, but you may find some of the younger OBs to be better at the follow up and compassion side of things. Dr. Martinez is great.
Unfortunately there is probably a level of gatekeeping that you'll never be able to get past because the practice is huge. Also, they deal with m/cs in the first trimester every day, as they are so common. I wish you the best, OP! The first trimester is so difficult, especially if you've experienced miscarriage in the past. |
Anonymous
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Hi!
I am so sorry that this happening to you. Dr Macri is great. Please call the office staff and ask to speak to the office manager, she oversees all the assistants who field phonecalls, or email dr. Macri through myhealth, or get in touch with fadia the triage nurse. You will need to hcgs if it doubles in 48 hours great. If no usually it's not a good outcome. But one number point tells you nothing. |
Anonymous
| Two |
Anonymous
| OP again. Thank you all so much for your helpful and kind comments. I had another appt in the building today, so I stopped by and went to the office manager's office (Rachel, I think). She was incredibly kind, tracked down the messages, and apologized for the delays. It also turns out that in fact the test finally got ordered yesterday, but the assistant was out sick today and so no one had called me to tell me. All very frustrating, but I was feeling better after talking with Rachel, and at least now the test is done. Wish me better numbers than last time!!! And thanks again. |
Anonymous
| OP, fingers crossed for you!! For what it's worth, I am a GW MFA patient who struggled with infertility (not the same thing as a miscarriage) but I did find that for going in for blood tests, it saved a lot of time not bothering with "my" doctor. I just would call and tell them I was Dr. X's patient, needed a beta test, stat, and that if it was necessary, I was fine with seeing a nurse practitioner or whichever doc had availability THAT day. They were always able to fit me in same-day for a blood test, and then usually it was an NP calling me back. I understand you may want a little more hand-holding this time, but it also sounds like you just want results - so that could be something to try. |
Anonymous
| Thanks! PP, when I asked for tests stat, they (triage nurse) told me my insurance would charge me the difference. Did they agree to do them stat for you? |
Anonymous
| OP, sorry if I was unclear, by "stat" I meant "rush", as in - get me in today. I think I usually had to wait until the next day for results as they send out to their lab. But no, they never mentioned any "extra" when I asked for the results back as soon as possible. I am BCBS PPP, non federal, if that helps. |