AIBU not to want to be seen by the same sonographer again?

[mummyclarke1987]

Yesterday I had my 20w pregnancy scan. This is my second pregnancy and it took me a few months to conceive. Partly due to my pcos and partly due to stressing about getting pregnant. My bmi is in the high end currently 37 (size 18) I have not put any weight whatsoever since getting pregnant, however been apple shaped most of my extra weight in around my tummy always making it difficult to see the baby properly when having a ultrasound. However until yesterday no medical practitioner had made me feel bad about myself. They will always bring it up if they have to bad in a polite way.

The lady that perform the scan yesterday was an exception. She was pregnant too. She seemed very displeased and annoyed by the fact that she had to struggle to get good image, kept making faces and at the end she told me in a serious tone "I don't want to upset you but your bmi is a problem". She asked me to go back in the waiting room and have some water, so she can scan someone else and call me again later. I was cooperating perfectly and hoped that the views will be better with a full bladder.

I was called in 15 mins later by who I think was the lead sonographer. The pregnant lady was still in the room typing at the computer with her back turned to me and for the whole time I was there she did not speak to me or turned around to look at me. I was only spoken to my the lead sonographer who was a lot more pleasant and sympathetic. She managed to get some of the measurements but said I had to repeat the scan because it hadn't been possible to get all of them. She said it was a good start and that I did very well. She was very reassuring and professional.

I just think that the fact that the first sonographer was annoyed, then she threw that line at me "I don't want to upset you" as been pregnant and overweight is something I should be really upset about, combined with the fact that she did not turn her back to look at me again or acknowledged my existence, it just makes me not want to have anymore appointments with her. On the other hand she's pregnant too, she has a family and I wouldn't want to seem as if I'm complaining about her, because been a mother and pregnant as well, I'm thinking she might just be having a bad or long day and I wouldn't want to cause her any trouble at her work.

Please can you tell me if you think I'm been unreasonable?

Maybe the sonographer should have said she was finding it difficult because of OP's big bones.

@User12879923378 Sonographers on this thread have previously stated they have been told to tell patients clearly why they have difficulty getting images whether it is due to the patient's high BMI or some other reason. If this reason causes medical issues which means it alters their treatment or causes them to have increased risks then it needs to be recorded in the notes.

All the people I know with BMIs over 30 are repeatedly told by HCPs to lose weight. This is backed up by the HCPs I know, with different jobs, who complain they have to repeatedly tell larger patients they need to lose weight due to the risks to their health and the difficulties in treating them.

They often have second people in the room at the time of a scan, sending reports, catching up with admin. I honestly doubt she gave a second thought to you being in the room. I've had this with gyne appointments too, people working at the desk.

At my 6 week post natal check, the consultant asked if his students could be in the room and examine me, obviously I agreed, I'm not shy.

He got a speculum out and opened my vagina up, "oh you're ovulating, come and look, she's ovulating...." he proceeded to show each of the students how he could tell. It was alright, I'm not fussy, but then, he put his hand on my fat belly and wobbled it and said "you're going to have to shift some of this though, my girl". Omg, I was mortified. He wasn't wrong though.

This was 20+ years ago, I didn't even have check ups at the hospital with my others. So don't panic new moms to be, I just got unlucky.

I think it was rude and unnecessary. If the stomach scan is a problem, they can go in vaginally. There was no need to reference bmi and upset the lady at what is already a vulnerable moment.

I think YABU. I recently had a 20 week scan and they couldn't get the final measurement of the heart and I was told it was because of how the baby was positioned. I diligently went out for a walk and a cup of tea and went back to have the scan finished by another technician. I didn't see the first one again.. .

1. If the first hadn't stated why they couldn't get the measurements I would have gone off feeling worried about the baby.
2. They are there to do a job not be my friend, I didn't expect the first to pop in and say hi.
3. I couldn't tell you what either of their facial expressions were like as I was watching my baby. But I imagine she was concentrating: frustrated at not being able to get the images and her face mirrored this.

You are obviously very sensitive about your weight. She stated a fact - and put it in a sensitive way IMO. Let it go.

I also don't see what the sonographer did wrong. She explained, factually, why she was struggling to get the images she needed. She then sought help from a more senior colleague who was able to complete the scan. She didn't speak to you again because there was no need to, she was no longer completing the scan. I'm really sorry that you felt offended op but I do think you are being over sensitive.

I agree with this.

I had a very grumpy sonographer for my first scan, second baby.
My husband was all ready to complain but I talked him down and convinced him (and myself) she was just being professional. (She probably hated her job/had a bad day or a difficult customer before me- but that wasn’t my fault) It’s a very nervous time for parents to be and all it would have taken was a smile. I also had a bad experience with a nurse at the drs surgery that I still think of. I think it’s worse when you are feeling vulnerable, otherwise you would be able to shrug this off. (Usually things like this wouldn’t affect me)
Can you ask who the appointment is with the next scan and just rearrange if it’s with her? I don’t think I ever saw the same person twice so you might be ok...
all the best for the rest of your preganany x x

User12879923378 You are being ridiculous! I cannot believe you are suggesting the sonograper should lie by ommision. This could have made the OP panic that there was something wrong with the baby or think the sonographer was incompetent. The truth was that the view was obstructed because of high bmi and there’s no sugarcoating that.

Over sensitive
The NHS are blunt abiut this
Same for me when I had back pain

Stop smoking and lose weight they told
Me

So I did ! It’s just facts nothing more

So we can tell people to quit smoking so it doesn’t drain our services but we have to dance around fat people so we don’t offend them?
I’m sorry but all she did was state a fact and how that affects medical care.

You have two ears for listening and one mouth for speaking - perhaps the moral is to listen more.

You're being over-sensitive.

Why do you expect the first sonographer to communicate with you while the second one was scanning you? It's quite right that she was focusing on her new task (which might have been nothing to do with you, just the computer she needed to use happened to be in that room) and allowing the second sonographer to concentrate on her job.

As for the huffing, if you're pregnant you may well huff when twisting round on a chair, pushing and manipulating with one hand, while controlling a computer with the other hand. She's finding life just as physically challenging as you.

I, too, have been told that not everything could be properly visualised because of my body fat, and I would need another scan etc. I had "View restricted by adiposity" on my notes. It's a statement of fact, not a judgement.

If we just stated " sorry can't get the views"

I guarantee the patient would want to know why and in my experience think the worst. I say this as a mother and sonographer.

Sometimes the truth is better as imagination runs wild.

And stating it's because she's big boned? Why should the sonographer had to lie

I try and explain a little of the physics behind it too.

I’m a size 20/22 and have never had a problem being scanned. Actually my last pregnancy I had the clearest photos, and managed a 6 week abdominal one.

Would you have just preferred she left the room mid scan with no expanation? That surely would have been worse not knowing what the problem was?!
Your bmi is way too high, you know this but are upset with a medical professional who explained to you why she couldnt complete what should be a routine scan because of your size?
I would have anticipated that coment tbh
YABU and precious. Nhs workers are busy you aren’t deserving of any more attention than anyone else.
Use your energies to eat healthily and have a good pregnancy and work to lower your bmi safely once baby is here.

In fact, at least half of women diagnosed with PCOS are of normal weight or lean. Some women with PCOS are even underweight

Raises hand - I'm lean PCOS

It's still an endocrine disorder, although lean PCOS are more likely to have insulin sensitivity rather than full on insulin resistance

My gynaecologist advised me to both eat low GL and put on weight to get my BMI up to 18.5 before he would start fertility treatment

I am prescribed metformin despite being low BMI because of my PCOS.

Lean PCOS does tend to present slightly differently to classic PCOS - we're less likely to have excess hair, although I still suffer from hormonal acne. Symptoms of classic PCOS can often be reversed through diet and weight loss, but that's not an option if you're lean PCOS

PCOS is like most things, a multi faceted condition

Bearing in mind as well that the foetuses are so tiny at 20ish weeks and that after a baby is born with an unexpected anomaly the antenatal scans are reviewed to see how and why things were missed. The sonographer is trying to do the best job they can and the images picked up through extra maternal fat aren’t as clear. They have a check-list of body parts and of angles and blood flow and measurements and if the images aren’t clear then it can take longer and there’ll be that HCP fear of missing something important.

It happened to me when I was pregnant with DC3. I had my DC really close together and never lost the weight before getting pregnant again so by the time I was pregnant with her, my BMI was similar to yours. I had three scans in total and two sonographers were great but I had a man one day who was just beyond rude. It wasn’t the fact he had mentioned my BMI but he very rudely and snarkily snapped “it’s the weight around your stomach, I just can’t see”, yet the next sonographer has no issue seeing. Made me cry so I know how you’re feeling. Luckily you will most likely never see her again.

@WhatToDoAboutWailmerGoneRogue

This is why obesity, alcoholism and drug abuse are all self inflicted yet the others you’ve thrown out there aren't.

People with untreated mental health problems can self-medicate with drugs, not sure I'd count that as 100% self-inflicted. Over-eating can be a mental illness - and some psychiatric drugs can cause weight gain, especially if combined with long in-patient stays.

Just saying it's not always straightforward.

Gp is lovely and midwife the same. They never make far or comment like that.

Sorry but if your GP and midwife haven’t commented to you about your morbid obesity and the effect it will have on your pregnancy, they aren’t “being nice”, they are being stupid. Your responses on here suggest a total lack of responsibility over your weight verging on complete denial. The Sonographer was a professional trying to do her job - OBVIOUSLY her senior colleague would be able to succeed where she failed. Please get a clue.

@mummyclarke1987

You aren't just unreasonable, you're butthurt personified. You have taken a purely factual statement about it being more difficult to scan you because of your BMI and blown it into some big unprofessional judgmental behaviour on the part of the sonographer. Then had an extra mental tantrum because she had her back turned to you working while the other sonographer examined you.

Would it have been better if she hadn't told you why she needed the second opinion of another sonographer? Cuz that would terrify most pregnant women since I think most would think something is wrong with the baby. Or if she lied to you?

Obesity can cause additional problems during pregnancy, people in the medical profession aren't doing women any favours by pretending otherwise.

"Is the nhs not to deal with overweight people or people with what you call 'self inflicted' conditions? Should we not care about people that are depressed, alcoholic or have problems with drugs?"

And you're displaying ignorance and being VERY unreasonable for calling depression a self inflicted condition then comparing it to alcohol and drug abuse.

On a side note every single person who has ever taken my blood has complained about my small, rolling veins. I've never taken it or them having to make an extra 2 to 4 attempts to take my blood personally.

Jesus Christ people the OP is already pregnant as are all other overweight or obese women who are gling for scans , what do you suggest she does ? Go on a crash diet during her pregnancy , what’s fucking done is done and she may well pursue weight loss after pregnancy but what use is there criticising someone in that difficult position just to get your point across because you feel superior being a slim person .

Thing is- it's just a fact. The reason it was harder to scan was because of maternal adipose tissue. If a sonographer can't get an accurate scan and has to ask someone back for instance they have to put why on the scan- just like if I can't do a test on someone I have to put why! You can't lie on the notes just to save someone's feelings. It's not a value judgement. It doesn't matter if the reason you are obese is PCOS or pies. The result is the same for a scan and if you can't see, you can't see. I've known people get upset because it's on the notes or because the hcp has had to use a large BP cuff, it's like would you rather us use the wrong one to save your blushes and get an incorrect result? In all honesty if you're fat I don't care really, and I don't care why, but I do care that you and your baby get the appropriate clinical treatment with the right equipment even if that bursts the bubble of 'I'm just a bit overweight' or 'I've got heavy bones'.

From a professional perspective I think she did a good job. She explained the problem, she tried to overcome it with the fuller bladder, she called a more senior colleague. You didn’t like her choice of words and you wanted her to look at you when you were seen by her colleague. If you dislike her you can decide what to done to but I don’t think it can be on the grounds of not being professional.

I had a really awful experience with a sonogram. It was the longest 30 minutes of my life. The sonographer asked me a really specific question during the scan and said 'hmm' when I answered. Me and DP looked at each other as it was clear something was wrong. She sent us out and said she needed a second opinion on something. I asked her what it was and she said 'nothing to worry about'. I asked her why she asked me that specific question and she told me it was just a routine thing that they ask. I was then called back in and a senior consultant was there to do the scan. Turns out there was something wrong with the baby, the question was not routine, and we potentially had some tough decisions to make. We were left in the dark during that long half an hour, and I would much rather the sonographer would've been bluntly honest to me. It's a slightly different scenario but I think this work both ways and there needs to be a happy medium. At least she was honest. She could have been more compassionate, sure, but at least she did the correct thing professionally and your scan was completed. At the end of the day, these are medical professionals who have to tell people day in day out that they have lost their babies, that their unborn children are unwell, etc. They are probably quite hardened themselves to telling people things they don't want to hear.

I think you need to let this go OP and enjoy your pregnancy. Congratulations

Sonographers only have a certain amount of time per scan. You where seen twice so took up more time so the first sonographer was probably playing catch up on the computer, that’s why she didn’t look/talk to you. She was concentrating.