Hellobee Boards

@mamimami: I make it a rule to not google medical complications I'm wayyy too neurotic to play that game. But I do know that my doc told me early on if I had any spotting at all, if I ever fell, ever had any injury whatsoever let her know immediately and they'd give me the rhogam then vs. at 28 weeks. I was super lucky to have an uneventful pregnancy (thus far) and had none of that, so I just had the shot at 28.

@Mrs. Jump Rope: Oh I've asked many people The whole thing is complicated by the fact that I've seen multiple docs. Concisely-- I was a patient of "OB-A" from the start of my pregnancy through 28 weeks when I switched to a midwife practice run by the same hospital group (so, same system, but different practitioner). However OB-A was on vacation during week 28 so they sent me to OB-B, her partner that week. I started seeing the midwives with week 30 and have continued with them. They are who I asked to run the cholesterol test and told me to "go any time" for that. Neither OB-B (at my 28 week appointment) nor the midwives at my 30, 32, 34 week appointments every mentioned my needing additional blood work done.

And yes, EXACTLY. If it was medically necessary why did no one tell me to go get it done? It's only because I'm anal and am trying to cross everything off my "to-do list" before the baby comes that I decided to get my cholesterol run now v. later since I have until September to do it. So if I'd just decided to put it off until this summer it wouldn't have been done it seems. That's what made me initially call and question all this, and the midwives say that OB-B is the one who put in the lab orders at 28 weeks "because you're rh-". So it seems to me that one of the following happened:

1) The tests WERE medically necessary for some reason and ordered appropriately by OB-B, but she forgot to tell me and then somehow they just fell between the cracks because I switched practices the next week (even though they use the same computer system/records??).

2) The tests were medically necessary but not supposed to be done yet. Like maybe when they do the rhogam shot they automatically put in orders to check your blood at birth to see if you need shot #2? And so the tests shouldn't have been run until I delivered but bc I wandered into the lab they did them early?

3) The tests were not medically necessary and I have no idea why they were ordered and now they are trying to say they were necessary to get me to pay for them.

@Mrs. Jump Rope: OB-B is the one who put in the orders for it, apparently, at my 28 week appointment. But I was at the lab after that appointment for my rhogam and tdap shot and no one drew my blood. And she never mentioned my needing a blood draw. Nor did the midwives ever mention they were waiting for me to get the blood work done. It's all very strange.

ETA: I am currently waiting on a call back from the office manager for OB-B. I explained the situation to her and that I wanted to know 1) why these tests were ordered and 2) why I was never told about them, before I'd be willing to pay for them. She said she'd investigate and get back to me.

@Mrs. Jump Rope: Almost. At 28 weeks I saw OB-B and it was a totally normal appointment except I had to go to the lab to get my rhogam and tdap shot (which OB-A had actually told me about early in pregnancy and was pre-planned for 28 weeks, she just happened to be on vacation that week so I saw her partner). OB-B never told me I needed any blood work, nor did I mention to her needing any (I didn't know I did then). So after the normal appointment she says okay head over to the lab for your rhogam and tdap (no scrip... they just send you across the hall, it is a small office).

At my 32 week appointment with the midwives, I mentioned I needed the cholesterol test and asked them to order it. They said no problem and put the orders in (it is a different/bigger building with a separate lab department-- there is no physical scrip, they just put the orders in the computer they said). I asked if I needed to call the lab to make an appointment for the blood draw and she said no, that the orders just stay in their system for 12 months and I can stop in literally any time they are open to get the draw and they will look me up by name. So days later I dropped in on the lab, told them I had blood work orders put in by the midwife and gave them my name. They took me back, took some blood, and sent me on my way. They didn't tell me what they were drawing for, nor was I given any paperwork after the draw.

I have no idea what/how the mistake could have happened. I don't fully know how their system works. It was a weird appointment because when I went in the nurse started telling me all these practice rules and I'm like "Ummm OB-B is not going to be my normal doctor, Ob-A is just on vacation this week so they booked me over here." and she was like "oh! I didn't know that I thought you were a transfer." So maybe they didn't look at my medical history and realize I'd had standard blood work done at 6 weeks? Maybe a bad code punched in? Maybe I did need the testing done but not until after labor? Maybe I needed the testing done and they forgot to tell me? I really have no clue... it is very confusing!

UPDATE:

Yea... they messed up. They did mean to order the tests, but the blood draw was supposed to happen at 28 weeks BEFORE my rhogam shot. The day I went to the lab, they just missed the order. They said it is standard practice to test for antibodies prior to the rhogam shot just to double-check that you haven't developed any (even though developing them before 28 weeks if you've had no bleeding or genetic testing done is exceedingly rare).

So the orders were just sitting in the system and when I went in for my cholesterol the lab then did everything currently pending. But, because I'd already had my rhogam shot, the test is totally useless because rhogam gives you a false positive automatically (or rather, the shot IS antibodies so it just makes it impossible to tell if you developed them before getting it).

So because they made a mistake and gave me a test a time when it was utterly worthless to me, they are taking care of the charge. yay!

(Of course that means I missed my only opportunity to have the test done because now it is too late... but I'm honestly not that upset about it because the risk of developing antibodies that early is VERY low and I have no risk factors and lots of docs don't even do the test as a routine thing... so I'm just not really worried about it).