Questions to Consider for Your Upcoming Doctor's Visit: Five Months Postpartum
At 22 years old, I have ADHD and took prenatal vitamins alongside a daily dose of 10,000 IU of vitamin D for my baby. I'm currently on Adderall XR, starting with 20 mg, but I'll be transitioning to 30 mg soon (the generic version from Actavis). With an upcoming appointment with my doctor, I’m wondering if there are specific issues I should raise. Lately, I’ve experienced several "close calls" while driving, both with deer and other vehicles. My ability to concentrate is significantly diminished compared to my pre-pregnancy state, which is concerning. Unfortunately, my situation seems to be deteriorating rather than improving. Without Adderall, I'm afraid I wouldn't be managing at all. My husband works full-time, making it less feasible for him to drive me around. I maintain a healthy diet and get adequate rest, but I feel something isn’t right. I was thinking about requesting a thyroid test, a complete blood count (CBC), and possibly a hormone assessment. My main goal is to find a way to feel better overall.
Answers (1)
3/27/2025, 4:40:32 AM
OpenHealth AI
Main Points: It’s important to address your diminished concentration and driving safety, considering both your ADHD management and overall wellness postpartum. Evaluate potential underlying issues, such as thyroid function and hormonal changes.
Explanation: After childbirth, many women experience various changes that may affect mental focus and energy levels. Factors such as fatigue, hormonal imbalances, and potential thyroid dysfunction can contribute to the symptoms you’re describing. Your request for a thyroid test, complete blood count (CBC), and hormone assessment is reasonable, as these can provide insights into your overall health and help identify any underlying issues.
Next Steps:
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Discuss Concentration and Driving Concerns: Start the conversation with your doctor by explaining your recent struggles with focus and the close calls while driving. This is crucial for your safety and could guide treatment adjustments for your ADHD.
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Request Specific Tests: As planned, ask about:
- Thyroid Function: A simple blood test to check for hypothyroidism or other thyroid issues, which can affect energy and concentration.
- Complete Blood Count (CBC): This test can help rule out anemia or infections that might contribute to fatigue.
- Hormonal Assessment: Discuss the possibility of checking hormone levels, as these can fluctuate significantly postpartum and affect mood and cognitive function.
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Monitor and Adjust Medication: Since you are transitioning to a higher dose of Adderall, keep track of any side effects and improvements in concentration. Your doctor can help you assess if the dosage is meeting your needs or if adjustments are necessary based on your postpartum condition.
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Prioritize Self-Care Strategies: Beyond medical assessments, continue maintaining a healthy diet and ensure you’re getting enough rest. Consider stress management techniques like mindfulness, gentle exercise, or support groups, which can also contribute positively to your mental health.
Remember, your health and safety are the top priorities, and it’s okay to seek help to address these concerns comprehensively. Let me know if you have more questions!
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7 Months Old) - **Weight:** 9 kg (good growth rate in spite of condition) - **Jaundice:** Continues to be present (yellow skin) - **Stools:** Remain pale/clay-colored - **Development:** Achieving appropriate milestones - **Energy:** Appears to have a good energy level - **Feeding:** Normal appetite --- ## QUESTIONS FOR r/AskDocs We have been informed this is **Type 2 Abernethy malformation** (portal vein present). **Three treatment avenues have been proposed:** ### Option 1: **Endovascular Coil Embolization** (minimally invasive approach) - A catheter is inserted via the leg vein to access the shunt and deploy coils/plugs to close the abnormal vessels - Pros: No surgical incision, minimal discomfort, short hospital stay (2-4 days), no scars, enhanced safety - Duration: 1-2 hours - Recovery: 2-4 weeks for jaundice to show improvement ### Option 2: **Open Surgical Intervention** - An incision in the abdomen to ligate abnormal vessels and redirect blood to the liver - Pros: Direct visualization, effective results - Cons: Surgical scar, longer recovery time (7-14 days in hospital) - Duration: 2-4 hours ### Option 3: **Liver Transplantation** - We have been advised this is not necessary as the portal vein is functional and liver health is improving. --- ## SPECIFIC QUESTIONS TO CONSIDER: 1. **With a functional portal vein (6.1 mm) and improving liver function (ALT normalized), is it advisable to pursue endovascular closure as the preferred treatment?** 2. **Despite ALT levels improving, the bilirubin remains consistently high (242). Should this be a cause for concern? Is there a prospect for it to normalize post shunt closure?** 3. **Are the hemangiomas/nodules (11.6×20.7 mm) linked to the shunt? Will they likely resolve following shunt repair?** 4. **How urgent is the proposed intervention? Is immediate action required, or is there flexibility to wait a few months?** 5. **What complications should we be vigilant for during the waiting period?** 6. **Regarding endovascular closure - what is the average success rate for infants aged 7 months? Are there concerns regarding the shunt size (9.9 mm)?** 7. **The measurement of the portal vein has shown improvement from 6.1 mm to 3.9 mm; should this be perceived as a positive sign or a reason for concern?** 8. **Are there special directives (diet modifications, medications) we should consider while awaiting the procedure?** 9. **Post-procedure, how long should we expect it might take for:** - Normalization of bilirubin levels? - Return of stool color to normal? - Resolution of jaundice? - Regression of hemangiomas? 10. **Can you recommend any specialized centers for pediatric Abernethy malformation treatments? We are located in Uzbekistan but are prepared to travel (to Turkey, Russia, South Korea, etc.)** --- ## ADDITIONAL INFORMATION - No family history of hepatic diseases - Pregnancy and delivery were normal - No additional congenital defects identified - Immunizations up to date - No history of bleeding disorders - No signs indicative of encephalopathy - Child is alert and engaged --- **I can supply actual MSCT images and comprehensive lab reports if they would be of assistance.** We sincerely appreciate any insights you can provide. We are striving to make the most informed decision regarding our daughter’s care and highly value expert medical opinions. **TL;DR:** 7-month-old diagnosed with Abernethy Type 2 malformation (9.9 mm portocaval shunt, patent portal vein). Liver functionality is improving (normalized ALT) while bilirubin remains elevated (242). Evaluating options between endovascular coil embolization and open surgery. Seeking expert advice on optimal treatment strategy and timing.