Thoughts on having pregnant NP as PCP for ongoing health issue?

[acepm1818]

I have been diagnosed with chronic sinusitis (a bad case of it) and my family has a history of Type II diabetes (I don't have it yet), so right now I am having to go into the doctor every two weeks for monitoring. At the practice I go to, I have been assigned to a female nurse practitioner, and she appears to be about 6 or 7 months pregnant. The first time I went in, I didn't even think she was a doctor because she was just wearing a big stretchy t-shirt and those legging things and some heels. No white coat. I figured she was a patient. It wasn't until I noticed her stethoscope and she called my name that I realized she was a doctor. My doctor, apparently.

Anyway, I like her fine, she is young and nice and very thorough (all vitals, heart listen, asks me questions, etc. at each and every visit), but since my condition requires ongoing monitoring, I am wondering if I should ask to be switched to a different PCP now. I'm also borderline high BP (138/88 last time ), so that's just another thing to be monitored. She is obviously going to go on maternity leave at some point and then someone else is going to have to learn my whole health history, which is a bit complicated. It might be easier to just switch now, while I am still new to the clinic. I have never had a female PCP before at all, let alone a pregnant one, so maybe I also have a subconscious preference for a male doctor, even though I know female doctors are just as good. I am also wondering if there is a difference in cost between seeing a NP or a MD. My visits with her are $86 each time. I'd prefer not to spend more than that. They probably have some male NPs too.

Another thing. She wears latex gloves for everything, even weighing me and taking BP, and wears a paper mask over her mouth when examining me. I don't know if it is because she is pregnant (I assume it might be), but it is kind of weird. I have noticed that none of the other doctors/nurses there do this, and it just makes me feel like I have massive germs or something.

Any thoughts on this? I would feel bad about asking to be switched (it almost feels rude to do so), but I also have to think about my ongoing care, and that it should be consistent with one PCP.

Your advice is appreciated, maybe if someone has had experience with something like this? Thanks much.

 

[wallenhaven]

If you like her and she is giving you good care, I would not make a change. There is a chance you wouldn't be able to get her back if you switched to someone else and didn't like them. Although having a female provider can take a little getting used to if you've always had men in the past, it is no big deal. And the fact that she is pregnant does not impact her medical skills or knowledge one bit. Neither does what she wears. I wouldn't expect a pregnant woman to wear a stiff uncomfortable white coat anyway, and I've noticed that a lot of nurse practitioners (and even some docs) don't ever wear a white coat. Sometimes it makes the patients feel more at ease and less like they are at the doctor's office.

It sounRAB like your maintenance care is pretty simple (vitals + basic exam), so that seems like something you can trust to one of the other docs or nurses there while she is away.

Oh, and about the latex gloves/mask. It doesn't matter. I really can't blame a woman for wanting to protect herself and her baby from all of the germs that she might encounter from patients. It's not you--it's everybody. Again, it doesn't impact the care you are getting one bit, so it is a non issue (unless you are allergic to latex--and simply disliking the yucky smell doesn't count ).

Best of luck.

 

[acepm1818]

Thanks, Wallenhaven. I guess I will stick with her, for better or for worse. I learned an interesting fact from another patient while in the waiting room last visit. The practice is currently not allowing patients with this specific NP to change to another provider there until further notice. This patient went on to say that it is because the practice does not want her to lose patients as a result of her pregnancy. Supposedly this is not a law, but the practice's own decision. I guess I understand--although it is interesting that I was assigned to her as a new patient at a time when she was already 6-7 months pregnant, without having a choice about it.

She is also talking about potentially starting me on BP med before she goes on maternity leave in another 3-4 weeks. Which makes me a little nervous, because I am usually borderline 140/90, and would prefer to stay off meRAB if at all possible. I am in favor of continuing to monitor it, but it seems like she is trying to push this onto me based on her own schedule. I asked her if it would just be temporary while she is away, and she basically said no, typically BP med is taken for life once started. I think this is an awfully big decision, and I don't see why it neeRAB to start now just because she is going away for a few months. Especially for a borderline case. Am I missing something??

But, if I wanted to make a change right now I would need to leave the practice and I really don't want to do that right now given how close the clinic is to my office and my insurance set-up.

Kind of in a dilemma about this. Leaning toward staying with her, but not feeling totally confident about it.

 

[Titchou]

Well, she can't make you take the meRAB. You are free to say that you really don't want to go down that road yet. And, it is possible to get off them. I've talked with my doctor about it but had a lot going on at the time and felt it wasn't the right time to try that. Perhaps if you show that the levels are stable or are lowering some, she won't even bring it up again. Or maybe she'll give you a scrip and you just say you'll think about taking them. I've done that before with meRAB. Certainly nothing wrong with it if you are comfortable with leaving things alone.