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#Post#: 45922--------------------------------------------------
Addressing a wrong medication
By: lacoloratura Date: January 20, 2020, 9:23 pm
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For a while now, I've had slightly elevated blood pressure. I've
also been undergoing fertility treatments for a couple of years.
Last fall, I was advised that I should get in to see my primary
care doctor right away to address this - I did, she looked at my
recent and past readings, and wasn't particularly concerned that
it was an emergency at the time. However, of course she agreed
that it needed to be addressed in the event of pregnancy. Both
my regular ob/gyn and the fertility clinic docs refused to
advise me about what bp med would be appropriate if I got
pregnant, and just said that my primary care doc could figure it
out.
Well, she did not inspire confidence at the time. She did a
little research there in the exam room, and she ended up
prescribing a medication that she pretty much said wasn't ideal,
but it looked like the best option out there. I filled the rx,
but opted not to take it, due to a combination of her lack of
concern at that time and the fact that I didn't really trust
that it would be safe if I got pregnant down the line.
Well, this weekend I had an embryo transfer, and so now I need
to get on it. The doctor who did my procedure mentioned that
beta blockers were the first line of treatment for bp in
pregnancy, and mentioned a particular one. Got home, checked my
existing prescription, and it's not a beta blocker. So I
messaged the fertility clinic, and the nurse who responded said
I'd have to go through my primary care, and maybe ask her to
contact my ob/gyn. I then went back and asked the pharmacist,
who said that this medication is not recommended for pregnant
women.
So I'm really looking forward to returning to my primary care
doc (if I can even get in to see her in less than a month! It's
so hard to get an appointment there, but an even longer wait to
reestablish care someplace new) and telling her that she got
this wrong. When I talk to her, how should I approach this? I
don't want to sound like I think she doesn't know what she's
doing, but - in this case, I really think she doesn't. She does
not treat pregnant women or even provide routine gynecological
care.
I could go to the same-day appointment clinic, but I'm not sure
that would be any better.
Oh, and last fall when I tried to get my ob/gyn to weigh in on
this, the nurse wouldn't even take my question to the doctor.
Recommendations for a script that won't offend my doctor?
#Post#: 45923--------------------------------------------------
Re: Addressing a wrong medication
By: Dazi Date: January 20, 2020, 9:35 pm
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I've only seen labetalol and nifedipine prescribed to pregnant
women with high blood pressure. There may be other options
though.
I'm surprised you are having such a hard time getting a straight
answer though. This shouldn't be happening. I'd honestly look to
replace both sets of doctors. OB/gyns can and do prescribe and
monitor their pregnant or TTC moms with proper hypertension
meds.
#Post#: 45924--------------------------------------------------
Re: Addressing a wrong medication
By: lacoloratura Date: January 20, 2020, 9:52 pm
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[quote author=Dazi link=topic=1597.msg45923#msg45923
date=1579577757]
I've only seen labetalol and nifedipine prescribed to pregnant
women with high blood pressure. There may be other options
though.
I'm surprised you are having such a hard time getting a straight
answer though. This shouldn't be happening. I'd honestly look to
replace both sets of doctors. OB/gyns can and do prescribe and
monitor their pregnant or TTC moms with proper hypertension
meds.
[/quote]
Interesting. The prescription I have is nifedipine, which the
pharmacist said was contraindicated. The fertility doc said
labetalol was the preferred drug. And I am definitely thinking
of finding new docs; I like my ob/gyn herself but the practice
she is in tends to be difficult to work with.
#Post#: 45925--------------------------------------------------
Re: Addressing a wrong medication
By: lakey Date: January 21, 2020, 12:03 am
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[quote]Oh, and last fall when I tried to get my ob/gyn to weigh
in on this, the nurse wouldn't even take my question to the
doctor.[/quote]
Glad to hear you're switching ob/gyns. A doctor should be
willing to answer your question, even if it is to explain to you
why they think the BP prescription should be handled by the
primary care physician.
#Post#: 45926--------------------------------------------------
Re: Addressing a wrong medication
By: Dazi Date: January 21, 2020, 3:38 am
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[quote author=lacoloratura link=topic=1597.msg45924#msg45924
date=1579578771]
[quote author=Dazi link=topic=1597.msg45923#msg45923
date=1579577757]
I've only seen labetalol and nifedipine prescribed to pregnant
women with high blood pressure. There may be other options
though.
I'm surprised you are having such a hard time getting a straight
answer though. This shouldn't be happening. I'd honestly look to
replace both sets of doctors. OB/gyns can and do prescribe and
monitor their pregnant or TTC moms with proper hypertension
meds.
[/quote]
Interesting. The prescription I have is nifedipine, which the
pharmacist said was contraindicated. The fertility doc said
labetalol was the preferred drug. And I am definitely thinking
of finding new docs; I like my ob/gyn herself but the practice
she is in tends to be difficult to work with.
[/quote]
Any chance that you have asthma? Beta blockers are not
recommended for asthmatics, as they can make the symptoms worse.
Otherwise, there's nothing wrong with calling your PCP and
letting them know your OB stated that labetalol is the preferred
medication during pregnancy, to please change it. You have to
advocate for yourself.
#Post#: 45934--------------------------------------------------
Re: Addressing a wrong medication
By: TootsNYC Date: January 21, 2020, 10:25 am
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As for a script:
"I brought up the blood pressure medications with the doctor,
and they looked it up and said that X is what I should be
taking, and that Y is contraindicated for pregnancy. But they
said you need to write the prescription. Would you do so?"
#Post#: 45939--------------------------------------------------
Re: Addressing a wrong medication
By: Hmmm Date: January 21, 2020, 12:24 pm
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Honestly, I wouldn't go back to a doctor who you do not have
confidence in. I would instead ask your OB/Gyn for a referral to
a new internist or GP. Or ask if there is a different GP that
you can see in the same practice. I also find it amazing the OB
won't write a prescription for the blood pressure medication.
It's been years since I was pregnant but during both
pregnancies, the OB acted as my primary physician and really
didn't want me going to a GP.
Now that you've done the embryo transfer, can you go back to
your OB and ask for them to prescribe the BP medication since
you'll be under routine care with him/her? I can see them not
wanting to prescribe if you aren't pregnant and going in
frequently to the OB but now it would seem they will see you
much more frequently than your GP.
#Post#: 45940--------------------------------------------------
Re: Addressing a wrong medication
By: Kimberami Date: January 21, 2020, 12:34 pm
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You have enough stress on you. Please find someone who will be
in your corner. I have a chronic illness, and I remember that my
OB/GYN and my Family Doctor worked as a team to help me chose
the proper medicines.
#Post#: 45963--------------------------------------------------
Re: Addressing a wrong medication
By: lacoloratura Date: January 21, 2020, 8:57 pm
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Thank you all for the suggestions and encouragement!
I know it seems like it should be an easy thing to bring up, but
I get anxious about saying the wrong thing and offending the
other person, and that makes me tongue-tied and not very
articulate. Seeing words in print is helpful and I will have
them in front of me when I call.
I don't have asthma, so that's not an issue. I just don't think
my doctor knows much at all about pregnancy. She was looking up
blood pressure meds on some sort of clinic database while she
was in the exam room with me, to find one safe for pregnant
women.
I was expecting a message from the fertility doctor (rather than
the nurse) today, but although I got a notification from them,
the message didn't show up. I have followed up on that and hope
to hear from them tomorrow.
#Post#: 46029--------------------------------------------------
Re: Addressing a wrong medication
By: lacoloratura Date: January 22, 2020, 8:50 pm
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A quick update - I was finally able to get an answer from my
ob/gyn, and she has ok'd the medication I already have, so I
won't have to go back to my primary. Thanks again for your help!
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