Sunday, October 12, 2008

"The Mecca"

I have an appointment tomorrow with a maternal fetal medicine physician. I'm excited, I want to be proactive with my next pregnancy. Not that I wasn't with Ethan, but this time, I want a physician who will not overlook anything.

When I got pregnant with Ethan, my fertility doctor released me to a high risk doctor. He recommended one of the doctors at the University high risk practice, his wife delivered with one of the doctors. So, I went there, feeling confident. I arrived and it was not what I expected. It was a very busy practice, it's at one of the teaching hospitals. I should've ran as fast as I could when I arrived, but I didn't. I waited forever to see someone, finally I meet with the nurse who does an extensive history and then tells me to make another appointment to actually meet Dr. Y, I was supposed to see Dr. X. I tell her this and she assures me that maybe next time I can switch to see Dr. X. But, she doesn't have any openings. She proceeds to tell me that over the course of my pregnancy I will see various doctors but Dr. X will be my primary MD.

Fine, I stay I make another appointment. I make it to my next appointment. Dr. Y walks in to my room, she's very soft spoken, meek, nice enough doctor. Again, I repeat my history and stress that this was a much anticipated pregnancy, a miracle baby for me. When we did IUI, I only had 1 mature follicle, and I thought it wasn't going to work. Only 1 follicle, well it turns out that's all I needed. And that 1 follicle ended up being my precious Ethan. She assures me she will do everything in her power to help me maintain a healthy pregnancy. She proceeds to do her exam (for a small woman she's kinda rough) and obtain my history, after a 2 hour or so appointment I leave there feeling confident. I am after all at the "mecca" of high risk pregnancies, and they got in under control. I will continue to take my blood pressure medications and so forth and they will do their job and monitor my precious, miracle baby.

Fast forward a couple months, all is going well, I'm still frustrated when I go there because it takes so long for me to actually get into my appointment. I arrive early every single time but still have to wait forever until I'm actually seen. But, I don't want to come off as pushy so I say nothing. After all, I'm pregnant nothing else matters. I've made it past the much awaited 12 weeks, I'm walking on clouds.

I have my first ultrasound there, I had a couple ultrasounds with my fertility doctor. All appears well, the subchorionic hematoma that was present at first is now gone, reabsorbed. I am told I can now exercise moderately to help control my weight, I have hypertension so weight control is an important measure to ward off preeclampsia. I'm at higher risk for preeclampsia since I have preexisting hypertension. But can you believe it my blood pressure is better than ever. Perfect. All seems to be well.

My pregnancy is progressing nicely. Week 29, I fail my glucose tolerance testing. I get a call from the clinic. I'm told to meet with a dietitian, I do as I'm told. Follow my diet, check my glucose 4 x a day. All is well. I have an appointment with my doctor, I go in, I have an ultrasound at 30 weeks. They are concerned about IUGR since I have hypertension. All appears to be well. They send me over to the clinic again, I wait almost 3-4 hours to be seen. This is really starting to piss me off. WTF. But, then I remember I'm pregnant, I shrug it off.

The door opens, it's Dr. G. What an ASSHOLE!!!!

The first thing out of his mouth is, "What are you going to do for birth control after this baby?". I go on to explain that this isn't really a problem for me since I have infertility issues. He checks the baby's heart rate tells me all is well. My blood pressure is under control, and tells me Dr. Y, whom by now I've become comfortable with, is no longer practicing. She was also pregnant, and had to deliver early. My appointment last maybe 5-10min. I realize, he didn't mention anything about the ultrasound I just had, or what the plan would be for the rest of my pregnancy. Nothing about non stress testing, nothing, zippo! Now, mind you I now have gestational diabetes and preexisting hypertension. As I'm walking out, one of the nurses tells me I have gestational diabetes I tell her I know, I've been to the diabetic teaching and I am testing as instructed. She is the 3rd person to tell me I have gestational diabetes. I want to scream, "Aren't you guys reading my chart, who the hell is following my pregnancy". Now I'm really pissed, and I have to go through this for the rest of my pregnancy.

I call my husband and tell him the latest. We agree to switch back to my regular OB whom I've known forever. I call her and she agrees to treat me, she also takes care of high risk pregnancies. We finally switch at 32 weeks. My first appointment with her is May 20th, the last day I heard my baby's heartbeat.

We have left the clinic, the mecca of high risk pregnancies, or so we thought. We are so happy, we're almost there at the finish line. Dr. J is wonderful, gentle and her staff is great. She tells me that she will begin NST twice a week. I question why I need this and she tells me even though all is well, she wants to make sure it really is. After all, I do have hypertension and now gestational diabetes, she also tells me she will see me weekly and by 34 weeks twice a week and she will repeat an ultrasound then. She also tells me she will not let me go beyond 39 weeks.

May 20th was the last day I felt Ethan. I remember it so vividly. I came home, happy I was finally getting the care I needed. I put Jason to bed then curl up and begin to read all of the handouts I just received at Dr. J's office. As I look at the pamphlets I run across one for pregnancy pictures. I write down the number, I'm thinking I will do this soon. After all, this might be my only pregnancy. I'm eating strawberries and fruit dip, it's my bedtime snack. I feel Ethan move, boy is he moving. I contemplate video recording my belly as it ripples because of his movement. But, I don't. Our camera needs charging. I sit in bed, and attempt to listen to his heart rate with my stethoscope but he kicks it. I get the hint and leave him alone. I go to bed, happy, thinking "Wow, this is really happening, we are having a baby".

Ethan died that night. This I know for sure.

I wish I would've known about hyperactivity being a warning sign. I'm a nurse, why didn't I know this. I live with this everyday.

I do have a list of questions to ask her, the maternal fetal medicine physician. One of my coworkers, works as a L&D nurse and she recommended her. She told me she's very conservative and thorough. When I called to make my appointment, her receptionist appeared to be genuinely concerned and professional. She explained what would take place during the first visit. She encouraged me to bring a list of questions.

I also had tons of blood work done per my fertility doctor's request. We had an appointment with him last week. He is checking different labs to check for blood clotting problems. He agreed to begin a cycle of injectibles in November. We are going to do Menopur and IUI. I hope it works.


c. said...

I hope it works, too.

I also have to say that there was nothing you could do to save Ethan. No amount of knowledge you could have had that would lead you to believe you would have anything but a healthy baby boy at the end of all of it.

I struggle with the guilt, too. We all do. One year out, I've learned that this behavious is yet another that we use to torture ourselves. If there was anything you could have done, you would have done it. Anything.

I'm sorry Ethan is not here. I know it's incredibly painful. Thinking of you.

Ya Chun said...

"I wish I would've known about hyperactivity being a warning sign. I'm a nurse, why didn't I know this. I live with this everyday."

I so get this. I guess c is right...I can think like that logically but I am not there yet emotionally.

Sounds like switching to a les hectic practice is a good move for you, on many levels. Good luck with the new doc and (((hugs))).

mrsmuelly said...

Me too. I'll be doing IVF in let's be pregnant again together.

I'm amazed at the lack of bedside manner from the specialists. The MFM I went to for my second pregnancy was highly recommended, but quite blunt and just plain wrong. He told me there was no way I had incompetent cervix just 10 days before my cervix opened up! Stupid man!!!

As for the guilt, I think we all have things that we "should have known". For me, I should have known that it was labor contractions and not gas - when does gas go in 4 minute increments? The bottom line is that we can't foresee everything. We don't know everything and that's so hard to accept. Plus, we made the best decisions we could at the time. Don't beat yourself up...and take comfort in knowing that you are not alone in the should have's.

Monica H said...

Thanks for sharing a little bit of Ethan and your pregnancy with us.

I am hoping and praying that this next cycle works and yo have competent doctors rallying for you.