Strange appointment with GP - should I have said I'm pregnant (again)?

[Blankel]

I had a GP appointment today for a UTI, I'm 36 weeks pregnant (so I'm very pregnant). I was asked to provide a urine sample on arrival. I said to the GP that I'm 36 weeks pregnant and I also said that my midwife had tested my urine and said there are nitrates and protein in there and that she had sent me to them for antibiotics. Then the GP asked for my symptoms and I told her. She then asked me to get on the scales, which I did and it said I'm 70.2kg, which she calculated as a BMI of 28 and told me my BMI is overweight. She then asked to measure my waist, which I said ok to, and it was 99cm. She told me my height to waist ratio was very high (my waist is just under 2/3 of my height) and that I should "work on that", recommending that I try to go for a daily walk and work on my diet to improve it - and that it might ease my symptoms. She then said to wait for the urine sample results and I'd get a phone call if I need antibiotics.

I feel a bit confused. I'm very clearly heavily pregnant so surely the whole issue of having a skewed height to waist ratio isn't a problem? Or am I missing something? Should I have reiterated that I'm pregnant? I didn't want to sound like an idiot...it was really obvious that I'm pregnant - she literally was measuring my waist so can't have missed my bump! Should I be trying to lose weight?

This is what I mean by you not understanding.

It was discussed in the telephone appointment. There is no need for a face to face or any kind of second appointment until after the results are in.

A telephone appointment, in my experience (and from a quick Google it is quite standard), would end with you being asked to go in for a sample post and to give the sample in.

Instead, you filled out an appointment form and waited to hear from them. They took 4 days and called you down to give your sample. Maybe they were waiting for you to come down and do it?

Your midwife wanted you to go to hospital or get an emergency appointment. When you had your phone appointment and believed no help was going to come immediately, you didn't take the option of attending hospital as your midwife had asked. You just... waited.

It doesn't sound like you're following instructions given to you. So I'm wondering if you misunderstood being asked to give a sample.

You're saying that's not what happened. You're saying they wanted to wait those 4 days before even collecting a sample. Fine. But then why not call your midwife on Monday when you knew you weren't getting a prescription so you could ask her what to do?

One post on here alone from the OP has nine yes nine nested quotes within it. That's got to be my personal MN reading record.

Hope you get it sorted out, OP. Take care. If you start to feel unwell, I'm guessing you know now what to do to get urgent medical help. I mean, you've been told often enough.

There's really no accounting for that GP appointment.

The midwife wanted me to have the emergency appointment and I had the emergency appointment over the phone exactly like the midwife said I should. After that, I followed the advice given to me at that emergency appointment by a medical professional. I've followed the most recent medical advice at every stage.

How is that not following the medical advice given to me? The only time I've not followed the medical advice is by listening to everyone on here telling me to ignore the GP and the hospital midwife telling me to wait for the results.

@longtompot

Wrong!!
As bloody explained.

My first post ended mid-sentence, on the word all.

My page refreshee and my post had been add too soon.

I then continued the post with an asterisk
*all the surgeries

To show I was continuing on the sentence from right above.

It was not a standalone statement.

I said "my mum has dealt with loads of surgeries. All the surgeries worked the same."

That is what I said. You can read it in the thread. I've also already pointed this out.

Is that enough now?

Jesus some of the replies on here are appalling.

ok, the OP could have stood her ground a bit more, but clearly she hasn’t felt able to do this - she has sought medical attention for herself though, and actually has been quite proactive in doing this. It doesn’t sound to me like anyone has raised this as an urgent issue - even the midwife on Sunday.

I am not saying that the OP has necessarily been given the correct advice over the course of the week, but how would she know that? Give her a break.

OP I’m glad you have called - at least now you know that this needs to be followed up quickly and can be firm when 111 call you back. UTI’s are horrible.

And none of her posts suggest that her husband is preventing her from getting medical attention - only that they have disagreed over whether it’s necessary. Has no one else ever done this?

YANBU about the GP appointment but YABU for not kicking up a huge fuss and getting some treatment sooner for a UTI while pregnant. If it causes pre-term Labour you’ll really regret not having argued your case and kept on at anyone and
everyone until you felt you were understood and getting proper treatment. It’s sometimes necessary to be very persistent with the nhs unfortunately (It should be like that and I really wish it wasn’t like that but it is).

I completely agree with you if I'd known but, truthfully, how is a non-medical professional supposed to know that they're not being given the correct treatment? The midwife said to see the GP (and the NHS website says to see a GP if you're pregnant and have a UTI) - I saw the GP. I have no idea whether their advice to wait for the form/sample/results was within the guidelines and just assumed that it was...until I had reason to believe otherwise.

Thank you. The row was pretty much that he thinks I should follow the medical advice from medical professionals and I think I should be following the medical advice from a bunch of women on a parenting forum 😂Objectively, I'm the one who sounds like a nutter but he's being accused of being medically negligent.

I get that, but you also said the following which implies you think the op isn't being truthful about her experience because, in your experience, this is how all the surgeries you have encountered since you were a kid have worked in the same way. Fwiw mine doesn't ask you to come in before your appointment to give a sample, you do it when you come in for the appointment and they call you back later if it needs following up. The way your surgeries do it seems a much better way as they have the info before you come in.

I said that all the surgeries my mum had dealt with before and after vivid have worked the same.

Try reading.

Last time my son needed to fice a sample was about 7 years ago and our surgery also tell you t get a sample tube from reception, hand in sample and appointment will follow if necessary.

Same for the surgery in my hometown as a kid.

That's more than a dozen surgeries I've had experience with that work like that.

Hi @Blankel re the disagreement with your husband and who is right I don't think the decision is clear cut.

Where a UTI is untreated it can cause premature labour. I suspect the 111 advice of speak to the GP assumes a very new infection. You've had a suspected UTI for a while now so I don't agree the standard advice now applies to you and the situation should be escalated - I see you've called 111 and are awaiting a call back.

Just in case it helps the NICE guidelines for suspected UTI in pregnant women confirms antibiotics ought to be given immediately (cks.nice.org.uk/topics/urinary-tract-infection-lower-women/management/uti-in-pregnancy-no-visible-haematuria/) this is because untreated UTI's can cause premature labour.

Hope you get better soon.

I've just had my annual blood tests including kidney function, a week before I had been prescribed thimethoprim for a uti, my bloods came back diagnosing an acute kidney injury, they wanted me to go straight to hospital & until I told the doctor I had been on trimethoprim which can mess kidney function bloods up. The best thing was that it was the same doctor who had prescribed them.

Untreated infections are really serious.
as a mum you’ll get a lot better about following your gut instinct regarding your child’s health. This will include ignoring your dh who ‘shuts down when things get serious’
Sleep deprived at the mo so struggling not to make this sound patronising sorry 🤣

Thanks, it's all fine now but definitely changed my attitude toward advocating for myself when it comes to healthcare. It's not being difficult, it's pushing for what you need.

When you have your baby it will be the same - chasing up appointments, insisting on tests, researching, asking questions. One of mine had a severe cows' milk allergy and I was told there was nothing wrong, for example, until I pushed for a referral.

I think you've got some good advice on this thread so you can decide what to do now. This is a good time to learn to be persistent and make yourself heard, though, before your baby is here.

OP if you've got nitrates in your urine you definitely have an infection.
Protein can be from a few different causes but nitrates are an actual waste product from the bacteria and if they're showing up it also suggests quite a high colony count.
They should have started you on some sort of antibiotic while waiting for the sample to come back, then changing as necessary depending on the sensitivity results.

Everyone involved in this scenario has behaved oddly on my opinion!! The OP by not saying to the GP 1) is it not wise to start antibiotics now considering I’m heavily pregnant and there are risks involved with a UTI and 2)for not questioning dietary and weight loss advice given to her by the GP.
The partner for not getting on this - everyone knows that UTIs and pregnancy are a dangerous combo, why is he not advocating for her? And finally the GP - goes without saying how weird they were! Tbh I’d just turn up at triage and get some! You seem very keen on rules OP..! Just go! Yes they say to ring but you’ve been ringing people and filling in forms all week! Just go to hospital and get your antibiotics!
tbh when me or even my daughter (age 7) has had a UTI they don’t even ask for a sample..they prescribe on symptoms alone! (Or a quick dipstick)

And I really agree with other posters who say you have to start pushing for what you need, especially now you’re about to become a mother. Blindly following the system or the “pathway” or whatever they call it can lead to inadequate care tbh:they’re busy and although great when it comes to life or death, the stuff inbetween can slip through the net.

Hope you’re okay, OP, and that 111 last night or someone today can help.

I don’t really think it’s that odd on the OP’s part: I didn’t know about UTIs and pregnancy, and I’ve been pregnant and also got UTIs often, but no one ever told me to be especially careful/worried about them during pregnancy. OP really can’t be expected to have this medical knowledge.

And when you’re in a room with someone and literally JUST opened with you’re 36 weeks pregnant and midwife this and midwife that, surely you assume they actually processed that you are pregnant. Only afterwards was OP wondering if the GP maybe, I don’t know, didn’t listen to her at all, or somehow managed to forget the preceding minutes.

May I suggest, at the end of all this, you make sure with the pharmacist that you have been prescribed antibiotics suitable for taking during pregnancy, if they come via your GP

That is a very good point; you can just imagine this getting into another mix up!

Thanks everyone. I didn't really know a UTI was that serious during pregnancy - the internet says it can be but the internet says everything can be a risk during pregnancy.

NHS 111 didn't call back last night so I phoned my GP this morning and they gave me a phone appointment with a different GP. That GP phoned back and said that they wouldn't prescribe antibiotics at this stage of the pregnancy anyway because it's not safe. I tried calling my midwife but no answer (presumably busy with another patient) so I've left her a message.

I have to say I’m totally confused by this..! I have never, in my many pregnancies, EVER been told that antibiotics were not safe during the third trimester. Come
on OP - surely you have Google?! Plenty of people take antibiotics during the third trimester, before labour, during labour…

I’d be looking to change GP surgeries! Keep calling your midwife, or failing that the maternity unit at the hospital for advice.

Being fair I couldn't have told you a UTI was serious in pregnancy, either. Most of us are only pregnant once or twice in our lifetime and not everyone has medical knowledge. I found out the hard way that pregnancy lowers your immunity. And yes they can give antibiotics at 35/36 weeks.

Hope you're OK and get sorted soon.

Unfortunately, this GP surgery (who have never been anything less than awful) are the only surgery available for our address. I phoned the Maternity Unit at the hospital last night and they said to wait and take paracetamol.