high risk pregnancy - blood clotting - need to find a new Dr....

Hello

This is my 2nd pregnancy, and I am 3 months preggo. I have a 1 yr old daughter now. My last pregnancy, I saw Dr. Kofinas (in Garden City) and he was great. I would be going again for this pregnancy, but he doesn't take my insurance this time around. Today was my first appt. with another perinatologist at North Shore LIJ. A little background...I have factor V Leiden, MTHFR, Protein S def., activated protein C resistence...and there are a few others...needless to say, last pregnancy I was taking lovenox 2x a day and baby aspirin and gave birth to a very healthy baby.
I am nervous about this pregnancy because last time I did also end up on bedrest and had my daughter 4 weeks early.
The Dr. that I saw today asked me why I was taking lovenox. I told him I had factor V, and started naming some other things, he said, "5% of the population have it, you don't need to be on it!" I have a cousin who lost her baby 1 week before the due date from blood clotting, she didn't know she had any problems. Last pregnancy I told him that I had a lot of blood clots in the placenta, he told me that Dr Kofinas tells everyone that. (I didn't like that so much...I rust Dr Kofinas 100%)

So now, he tells me that he will talk to my OB (who also told me that I WILL be taking lovenox 2 times a day for the entire pregnancy) and said that he will figure some things out with her. Bottom line, he doesn't want me on blood thinners. Within 5 minutes of meeting me, and not reviewing the copies of blood work that I brought him, he tells me that I am a very healthy person with no problems...not even knowing my experiences with the last pregnancy....

I wanted to know if someone could recommend a high risk dr, who specializes in blood clotting and who is proactive...God forbid I did stop the blood thinners, and something happen...I would be crushed. I would love to go to Dr Kofinas, but that's not an option for me, sadly.

I appreciate all of the advice/recommendations!!

Thank you!

LeeAnn

Message edited 12/18/2008 1:34:49 AM.

Re: high risk pregnancy - blood clotting - need to find a new Dr....

I can give you the name of an amazing group at columbia (they deliver if you want to switch OR they will work with your regular OB if you want to see them with your regular OB).

But if you want to stay on the island...
Victor Klein is high risk but not sure if he specializes in blood disorders though - he delivers though so you wouldn't see him and your own OB.

But if you want to stick with LIJ - I haven't seen this doctor but this Maternal Fetal doctor has a very good reputation:

Adiel Fleischer, MD
270-05 76th Avenue
New Hyde Park, NY 11040
Phone: (718) 470-7636
Fax: (718) 470-0650

I have never heard of Dr. Kofinas before this board.

Re: high risk pregnancy - blood clotting - need to find a new Dr....

I have the MTHFR and the low Protein S-- I see a high risk doc in Manhattan... Only thing extra I do is take an extra 400 mcg of folic acid and a baby aspirin though. A hematologist told me I didn't even need to take that. I guess it depends on how severe your definceincies are.

Let me know if you want my doc's info.

Re: high risk pregnancy - blood clotting - need to find a new Dr....

I saw Dr. Mackenzie at Madonna in Brightwaters and I liked him. But I only saw him once. I have some blood clotting issues as well.

Re: high risk pregnancy - blood clotting - need to find a new Dr....

UGH, when I was diagnosed with Homozygous MTHFR, I KNEW that I wanted to be on Lovenox after discussing it with my sister who has the same diagnosis

My initial OB wanted to take a "wait and see approach" and I was not comfortable with that so I switched OB's.

My new OB said Lovenox is not harmful and there is really no harm in taking it. He sent me right to the Hematologist who prescribed me the Lovenox

I also went to a MFM (maternal fetal medicine / high risk) doctor and she too, after speaking with my for 5 minutes said "I do not think you need the lovenox"...I politely told her that I WAS going to take it to be on the safe side and I did

no problems, I was induced at 39 weeks and had a c-section to deliver my dd at a healthy 9 1/2 lbs

Re: high risk pregnancy - blood clotting - need to find a new Dr....

Message edited 12/17/2008 8:51:45 PM.

Re: high risk pregnancy - blood clotting - need to find a new Dr....

Hello lillykat

Thank you for getting back to me!

It's funny, because My sister in law is seeing Dr. Klein right now, she is having natural triplets! He specializes in multiples. I asked her if he does specialize in blood clotting and she said no...(that was a few weeks ago actually!) He is a really nice Dr. too, I went with her to his office for her appt.

How did you hear about Adiel Fleischer, MD from LIJ?

I really do love my OB, so it would be hard for me to switch, she has been really great, and was so wonderful with my last pregnancy...I would be interested if there is a high risk Dr for blood clotting at Columbia though. I am going to try and follow through tomorrow with a few of the recommendations that I got from here today, and try to find out more about them and their practice...

Thank you so much for your recommendation!

(o:

Lee'Ann

Message edited 12/18/2008 1:34:23 AM.

Re: high risk pregnancy - blood clotting - need to find a new Dr....

I wanted to thank everyone for getting back to me!

I really appreciate it! I will follow through with the recommendations that were given!

Thanks so much!!

Lee'Ann

Re: high risk pregnancy - blood clotting - need to find a new Dr....

I too have 2 blood clotting disorders.
I go to David Bergman (high risk) in Great Neck who is affiliated w/ North Shore. So far, I'm very happy. He would become your obgyn. You wouldn't need to see two doctors.
FM me if you have any questions. I actually found him on these boards.

Re: high risk pregnancy - blood clotting - need to find a new Dr....

I see Dr. Mackenzie at Madonna Perinatal. I too have some sort of non-specific clotting disorder as well- Elevated homocysteine levels, Borderline + Anticardiolipin AB, +MTHFR, + ANA. But everything is very borderline so I am not on Lovenox. He has me in 4mg Folic Acid (for the high homocysteine) and a baby ASA.

He was hesitant to throw me on lovenox bc of the borderline nature of the labs. About week 6 into my pregancy he told me I have a tiny hematoma in the chorion and explained it to me as I had a bruise there and in fact Lovenox would only make the bleeding worse in this case.

So it is very tricky with me. He didnt take me off the baby ASA bc he cant ignore the fact that there could be a clotting disorder going on and said in fact that other High Risks Drs might have made me stop it (but I was happy he didnt).

So, my point is, every Dr is different as well as every patient. I do highly rec. him and do trust him. I hear he is very good by so many others.

HTH!