High risk?? WTF!

L2D
on 1/19/12 9:44 am - Canada
Hey there, I'm new to this forum..here's my story.
I had my RNY Aug 31/10, so I'm just about 17 months out. I have 2 kids, 17 and 11 yrs old. So far I've lost 123 lbs (and stalled). I'm about 30 lbs from my goal weight...
I got married last April and my new hubby and I have decided to try to have a baby.
3 months after surgery I actually DID get pregnant, accidentally of course...and we decided to terminate the pregancy. It was the best choice for me physically at the time. I was having a rough recovery, my labs were all over the place, I was barely able to keep myself nourished and couldn't risk  trying to nourish a fetus properly at that time. It was a sad time for us, but we made it through.
Here we are one year later and my health has improved 100%, I'm eating pretty much normally now and I just got my IUD taken out 2 days ago.
Unfortunately, my family doctor is pretty clueless when it comes to barriatric surgery, in fact I've taught her everything she knows! lol...she asked that I start taking folic acid now, but doesn't know how much I should take...she also asked that I start prenatal vitams now...which I'm fine with...and I asked her if I would be seeing her throughout my pregnancy or what the deal was...she said I would see her for the first half of the pregancy and then she would refer me to a OBGYN. I asked her if that was normal, since she's just a GP..but she said I wasn't considered high risk (I'm 36, 2 healthy pregnancies).
I decided to email my barriatric nutritionist at the hospital where I had my surgery just to see what, if anything, I should change about my regular vitamin intake as well. She's doing some research to see what, if anything, I need to increase...but then told me that I should be referred ASAP to a high risk OBGYN BEFORE I EVEN GET PREGNANT!
NOW I'M FREAKING OUT! 
Why would I be considered high risk? Just because of my surgery? Was anyone else told this?
Remember, I have no health problems, never had any problems with my pregnancies, my surgery is the only major thing that's ever happened to me medically.
Any info/advice would be appreciated.
MusicMaryn
on 1/19/12 9:54 am - San Jose, CA
DO NOT PANIC!  A lot of OB's and even Bari professionals get nervous with a post-op pregnant woman and automatically label us "high risk pg."  There really is hardly any difference between a post-op pregnancy and a non-WLS pregnancy.  I too had RNY and I'm now 15.5 wks pg.  Here's the deal...  We do need to monitor our vitamin levels - it's suggested to have the full panel of vites checked every trimester.  The baby will take all of the nutrients it needs first and then the pg mommy gets whatever is left over.  With RNY we have a malabsoption concern.  All that means is that we get to be a little more rigorous with our protein and vitamin intake.  We do add in some healthy carbs (needed to stay out of ketosis - bad for baby.)  Most pg post-ops simply add a prenatal vitamin and folic to their daily vitamin regimin.  My OB suggested that I take 4mg of folic per day.  I had to order that online as all you can get in stores is up to about 800mcg.  My OB said that you cannot OD on folic.  She just checked my folic levels 4 wks ago and I'm at the top of the normal range.  (I was taking them for 18 mos before I got pg - took me a year and she wanted me to start taking them 6 mos prior to TTC.)

Now, I'm 41 so being over 40 automatically labels me as "high risk."  But here's the deal... as a very healthy adult (I lost 150 lbs and cured all of my comorbidities) my OB said that technically I'm "high risk" but she will only treat me as high risk if the need arises.  OH... and with being "high risk" we get more ultrasounds.  Which btw are a very good thing... it is so awesome to see the little one squirming around inside of you.

So really... do not panic!  I would order a good high level of folic online (ie: 4mg) and add a prenatal to your vites now.  There really is no correlation between WLS and pregnancy issues or birth defects anymore than non-WLS mommies.  So breathe, take your vites, and see if you can find an OB that has WLS patient experience.  You'll be fine!
Our little miracle baby boy is on his way!
Lilypie Maternity tickers
    
(deactivated member)
on 1/19/12 9:18 pm - Woodbridge, VA
Calm down. Whether you carry the label of "high risk" or not doesn't change the facts. I would, quite frankly, ignore the nutritionist - she is NOT an OB. Hell, most nutritionists, even in bariatric practices, are even WRONG in the advice they give to bariatric patients regarding things like supplements. For surgical issues, talk to a surgeon. For pregnancy issues, talk to an OB. Period.
hockeybabe2u
on 1/19/12 11:08 pm - Allegan, MI
I was considered high-risk because of my age (turned 35 during my 1st post-op baby and 38 with my 2nd) and due to my surgery. I seen my midwife through-out my pregnancies and had a few appointments with the high-risk doctor, along with more ultra-sounds. Like the PP poster said, make sure to get your vitamin levels checked regulary. I would start by getting them done ASAP to see where they are and what you might need to take more or less of. I did this before I started taking extras of anything (besides folic acid...like mentioned before, you can't overdose on and is good for baby) and my labs came back good (my iron level was on the high side which is unusual for weight loss patients) and they told me to continue taking what I was taking except take my iron every other day verses every day. Then have your levels checked each trimester and go from there with the results! Best of luck to you!

 Lilypie - (XOJP)Lilypie - (5Vrv)Lilypie - (DpEi)Lilypie - (qPOc)



 

Just P
on 1/20/12 12:23 am - DC
I am the same age as you and I had my surgery almost 9 years ago and I was label High Risk.   After 35 you are considered High Risk.  The only thing with High Risk is they check for the likely hood of you haveing a down symdrome or retarded child.  If you rank high they will recommend other testing.  Because of the surgery they want to closely monitor the growth of the baby.  No big deal.  Its actually a good thing.  Make sure you are taking all your required vitamins.  If you are taking a prenatal, iron, and calcium then you are okay.  If you need something extra they will know from your blood work. 
Mz.P Living and Loving Life!

Lilypie Maternity tickers
L2D
on 1/20/12 1:26 am - Canada
Thanks everyone for your replies so far. I've asked my doctor to refer me to a high risk OBGYN so we'll see how it goes!!
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