Sunday, January 9, 2011

I'm obviously a very emotional pregnant person

**WARNING: This post is full of the rants of a post-loss pregnant type (me). It's long and includes dialogue that is likely only interesting to me. Attempt to read at your own risk! :-)

Reader's Digest Version: I'm just about 29 weeks, c-section scheduled (after MUCH drama) for 3/9/11. I have an excess of amniotic fluid (28cm), but peri didn't see any digestive blockages in the baby, so we will just "watch it" like we do with everything else. I'm trying to stay sane during my last 8 weeks of pregnancy, and hoping all this time and effort results in a living, healthy little boy.

The Long Version: The good news is that I have a c-section date of March 9th (37 weeks according to them, 37+4 according to my LMP). It seems both just around the corner, and so far away at the same time. I had a traumatic appointment with my OB two days ago. I hadn't had a visit for 5 weeks, and I actually didn't see him the last time I was there. So, to be fair, he hadn't seen me in about 9 weeks. When the nurse took me to the room she said, "Oh, it's so nice to see you. I was thinking about you yesterday and how you were doing." My BP was good, my weight (ugh!) they did not hassle me about although I gained 10 (TEN!!!!) pounds in the past 5 weeks. Damn holidays! Threw on the doppler for a couple of seconds--read in at 130. "Looks great," she said. Dr. M came in and said, "okay, I guess it's time to schedule your c-section." Of course, I was completely excited to set a date. He said, "okay, so what about the 24th?" I must have given him a weird look, because he said, "The 24th of March. You're due March 30th." I was in such shock, my eyes welled up with tears and I said, "but I thought we had discussed 36 or 37 weeks." He said, "not unless you want an amnio." I said, "yes, yes, I thought that was the plan. Remember, my daughter died at 38.5 weeks?" By this time the tears had started squirting out of my eyes. He closed my chart and his calendar, and sheepishly said that he would call the perinatologist and work it out. I told him him, "I'm just caught completely off-guard by this. I really need for us to all be on the same page. I promise that I won't be pregnant at 38 weeks. I will take a knife to my abdomen and land myself in the E.R. by that point." He passed me a tissue and said, "we'll get this worked out." I left the office totally overwhelmed, confused, and frustrated, and completely fell to pieces. I was beyond stunned.

Flashback: When Chris and I met with this OB when I was like 6 weeks pregnant, based on Addison's birth and death, he offered up the care plan for this pregnancy. It looked something like this: More frequent monitoring, being followed closely by the perinatologist, Non-Stress Tests beginning at week 34, Amnio at 36-37 weeks and if all was well with that, delivery shortly thereafter. Now, 29 weeks into the pregnancy, this douchebag starts acting like I made the whole thing up. Trust me--I wish Addison had been a figment of my imagination. I wish I didn't live through that hell. I wish that I didn't question my every move now, and question the very ability of this baby within me to actually SEE the outside of my womb. So, I decided there were two possibilities: 1) He is changing the game plan completely; 2) He has no fucking idea who I am, and didn't even glance at my chart before entering the room to greet me. Wow. Neither option is very patient-friendly.

And after taking about an hour to compose myself (literally), I decided we would see what the perinatologist had to say. Luckily, I had an appointment with him 3 hours later, and Chris was planning to meet me there. Pretty immediately, the peri told me that he had spoken with Dr. M, and they set an amnio date for 36+9 and the c-section for the next day, assuming all looked well. I said, "he totally forgot who I was, didn't he?" He wobbled his head and, although it was evident he didn't want to throw his colleague under the bus, made it wordlessly clear that that was the case. There is more to the peri visit, but I feel a strong need to make a rant about my experiences with the so-called medical professionals I have dealt with over the past years.

My mom was a L&D nurse for about 30 years before deciding to go back to school to get her Masters degree. She is a Certified Nurse Midwife and works within an HMO wherein she does some time in the office for OB- and GYN-type issues (paps, 6 week delivery follow-ups, prenatal care, etc) and also does deliveries in a hospital setting (24 hour shifts). So she kinda knows about the business of babies--both the prenatal care, and actually delivery. She does get disgusted, at times, with how many of the OBs seem to just whip in and out of patient rooms, while the midwives give much more personalized care.

When I became pregnant with Calvin (late 2005) I was referred, by 2 co-workers, to a male OB within my insurance plan. They both loved him; I thought he was okay. At the end of the day, what the hell does an OB do anyway, unless you need a c-section? At 40+6 I cried my way into being admitted into the hospital, after being in prodromal labor for the past 2 days. Calvin wouldn't tolerate pitocin (decels with every "good" contraction), my cervix refused to dilate beyond 3cm, and I ended up with a c-section by an unknown doctor in my OB's practice. It was done under general anesthesia, by the way, because my epidural gave out on my left side, and they couldn't get a spinal in. Good times. Despite going home with a perfect baby, I had a level of mourning due to the type of delivery. I recently ran across some video of my husband, 2 of my sisters, and my mom in the nursey with Calvin during his first bath. That all happened while I was still unconscious in the recovery room. At the time, I thought the whole situation was terribly unfair, but I eventually came to terms with it.

And then I moved across the country to Georgia, and got pregnant in 2008. I was referred to a female OB by Chris' 2 cousins, who both delivered with her--one via c-section and one vaginally. She seemed very sweet, and had good bedside manner, and when the baby had no heartbeat around 10 weeks, she did the D&C. So when I got pregnant with Addison in early 2009, I decided to see her again. The care was fine (I was a very low-maintenance patient, as most of my questions were answered by my mom). All I wanted was a scheduled c-section, and to be awake for the delivery of my daughter. Jokingly, I always said (not directly to my doctor), "Can you cut a straight line? Great--I'm in!" My c-section was scheduled for 38+6. And then, a couple of weeks before the "big day," my OB noticed that I was scheduled for a day under 39 weeks. I was advised they had a new office policy wherein c-sections could not be scheduled earlier than 1 week before their due date without good cause. I was ONE DAY earlier than 39 weeks, but it didn't matter. She changed the c-section to 39+3. I cried (again), but there was nothing I could do. I ended up being a moot point because the night of 38+3 I ended up in the hospital due to decreased fetal movement. Addison was delivered the next morning via c-section, by an unknown doctor in my OB's practice, and taken to NICU. The rest is history.

When I got pregnant this time, I didn't know who to see. I didn't want to see my last female OB again, mostly because of insensitive things that were said by a few of the other OBs who did rounds in the hospital while I was still in-patient after having Addison. I felt like they were not in contact with the Neonatologist at all, and didn't really have a vested interest in what happened to Addison. They were purely concerned with making sure I felt they weren't at "fault" with what happened to her. I felt there was a lot of ass-covering going on, and it made me feel, in a roundabout way, that they would rather have me blame myself for what happened to Addision, than to even think about the POSSIBILITY that their practice was responsible for the outcome. I know there is no blame to be placed with my OB or her practice, but I couldn't tolerate how I was treated after the fact. I knew I couldn't go back there.

The nurse with the peri's office (I was followed closely with Addison because I was of "advanced maternal age"), who is sadly no longer there, referred me to the practice I am currently seeing. Dr. M had been given good reviews by his patients, he delivered at the sister hospital where I had Addison (I don't want to go to the same hospital this time), he was close, affiliated with the same peri practice, and within my insurance coverage. All that sounded good enough to me. And, again, what the hell does an OB do other than cut a straight line at c-section time? All they do is WATCH. I had a subchorionic hemorrhage. We watched. I now have an over-abundance of amniotic fluid. We will watch. The LEAST he could do is fucking glance at my chart before he walks in to see me. The patient. The one who pays his bills. I have lost faith in him, but I feel I have no choice but to continue on because I'm so close. I really hope he CAN cut a straight line.

After a horrific experience at the hospital last time, and then watching Addison die. After hearing everyone involved (and not involved) attempt to cover their ass so they don't get a lawsuit slapped on them. After reading so much about cold cap therapy and wondering, endlessly, if that would have saved her. After suffering through my own slips in referring to this baby as "she" instead of the "he" that he is. After the subchorionic hemorrhage, bleeding so much for so long, almost losing hope. After just wishing for and wanting for this baby. I'm just spent, emotionally. I want to hope, I want to feel peace that he is okay. I don't think I'll be able to feel that until he's here and I can see with my own eyes that he is healthy.