Monday, November 30, 2009

Ahh, the clarity of hindsight (or, how I became the crazy mother)

As many of you may know, November is Prematurity Awareness Month (although it shares the month with diabetes, lung cancer, COPD, hospice, and Alzheimer's Disease... And lots of other happy things...)

So, in the name of prematurity awareness, I want to share part of my story with you guys in hopes that others will learn from my mistakes, and maybe some kid somewhere will be born healthier and happier for me doing so. Other preemie parents out there, I urge you to do the same on your blogs and maybe an expectant mother out there will learn that one thing that will keep her from walking in our shoes...

I think most mothers who have been down this road look back and see things that they think they should have seen back then. I guess that's true with most situations... But even though I can't go back and change the path of my pregnancy, if you know anyone, ANYONE who is having twins, or is experiencing the same issues I was, please help them be informed (Notice I said "inform" and not "scare." There is a difference.) Multiples are at a higher risk and should be treated as such.

So here's my story.

We found out we were pregnant in November of 2007. As soon as we found out I picked the new OB in a very reputable office. The doctor was young and I felt she would be fresh on all the new techniques and procedures, and she would also have the more experienced doctor in her office to rely on if she was unsure about something. I made an appointment with her and began the wait.

I bought loads of pregnancy books and started obsessing over foods. I based my meals and snacks around getting all my nutrients and eliminated artificial sweeteners and unheated deli meats. No caffeine for me, lots and lots of water and orange juice, and just the right amount of exercise. Oh, and when they say 12 oz of low-mercury fish, believe me when I say I had 12oz, no more, no less, of fish a week. And I started eating 4 apples a week because the latest research had shown it decreased the risk of asthma by some crazy percentage. I was a woman obsessed.

Then I started having some bleeding...

It was mostly dark brown. I had two or three pregnancy books I read daily, and all of them said bleeding is never a good thing, but it is a common thing. Dark brown is better than bright red. I called The Doctor after three days to see if I should come in, and The Nurse told me that if it worried me I could go to the ER.

Okay, wait, you tell me if I should be worried. This is during business hours. I can come in. Should I worry, or is this normal?

The Nurse then said if it continued for 3 more hours to go to the ER. Okay, I've been bleeding for three days. What makes three more hours so different?

But I just said okay. I didn't argue.

I had no answers when I got off the phone, and I was frustrated, so I called my PCP. The actual PCP called me back within 10 minutes, and actually gave me information I could use. Yes, brown blood is common, yes it might be a miscarriage but there is nothing that can be done to stop it at this stage of the pregnancy so just take it easy and go into the ER if the bleeding gets substantially worse.

Wow, a real answer. A real plan. I could live with that.

So a week or so later it was time for my first OB appointment. They set up an appointment for the next month then sent me for an ultrasound since I was still having some bleeding.

And that's when we found out our little peanut was actually two little peanuts. :) We were 6 weeks pregnant with twins! We had wanted twins so badly, and it was just surreal.

The next morning I called my OB and spoke with The Nurse again. I told her it was twins and that I knew how common it was for a baby to just disappear during the first trimester, and we wanted to do everything possible to keep them both in there and healthy. Can we move up our next appointment? See the doctor more frequently? Are there any additional supplements I need to be taking? Any extra precautions?

"Those all sound like good questions to ask The Doctor at your next appointment," she replied.

And I didn't argue. I was frustrated but I just let it go.

A week later I started bleeding again. Red this time, and more than before. I freaked out and they sent me in for another ultrasound. Everyone was still there and accounted for. Phew.

I had a follow-up appointment with the OB the next day and she told me then that I needed to take more folic acid since it was twins. I asked about seeing her more frequently and she said they typically start seeing the mother twice monthly starting at 24 weeks due to the increased chance of prematurity.

And I say ok.

Over the next few months the same types of issues continue to arise. I call the office to ask a question and, if I ever actually even got a reply, it was never a useful one.

Meds that were promised to be called in to the pharmacy immediately weren't called in for days.

I was frustrated, but I figured I was just overreacting. You know, crazy first time-mother-itis... I assumed all doctors' offices worked that way...

We had our 20-week ultrasound and everything looked really good. The only thing they saw was Aubrie having a slight heart murmur, but they told me that was common and they usually grow out of it. I researched vitamins and minerals that specifically help develop the baby's heart and started eating more foods that contained them just to be sure.

I became sick one week later with cramping and an upset stomach, but I didn't get worried until that Friday when I woke up with a fever. I called the office all morning, starting before office hours, and left messages asking what I needed to do. We were headed into the weekend and I didn't want to end up missing my window of opportunity to see The Doctor...

I called and called. Left message after message.

Finally I just got in my car and started driving there. They will see me today whether they want to or not. Thankfully, The Nurse called me back as I was headed that way. She told me The Doctor wanted me to go to the hospital OB floor for observation and tests. I did, and they had me pee in a cup and hooked me up to the contraction monitor.

I was having contractions. Not bad ones, but they were there. The hospital OB nurse said that was pretty common. A manual check of my cervix showed it was still closed. The hospital OB nurse told me my pee came back normal, but The Doctor was ordering an antibiotic for a UTI and sending me home, with an appointment not that coming Monday, but the Monday after. (The Doctor was going on vacation, see. That's why she didn't come by the hospital to check me out, and why she wouldn't see me the following week. She'd see me after she got back from vacation. A completely reasonable explanation. If she was going on vacation, then I must be fine.) The hospital OB nurse told me I didn't have to go home, that I could stay for longer. She actually tried to persuade me to stay. I told her I would do what The Doctor said... Obviously she's The Doctor and she knows what she's talking about.

The next week (you know, the week The Doctor was on vacation,) I had a baby.

Could my premature delivery have been prevented, or at least have been postponed a few weeks? I don't know. There's absolutely no way of knowing. Do I look at the situation emotionally and with perfect hindsight? You bet. Do I feel the doctor was negligent? I don't know. I don't know what's "normal," or what's common practice. I don't think she went above and beyond my any means, but was probably super-comfortable in her role of doing the minimum that is medically required. I've heard several times now that everybody is basically treated the same until they have a premature delivery or a dead baby. Until then we're all just paranoid mothers...

But you know what? I could have pushed. I could have fought. I could have changed doctors. I could have asked more questions and required better answers. Those are things I didn't know, but now I do know. And those are things I can pass on to other mothers.

Doctors aren't always right. Go with your instinct. If you don't like your doctor, or if your doctor doesn't go above and beyond to meet your needs and help you feel comfortable and educated, then FIND A NEW DOCTOR.

And even though this is mostly directed towards mothers-to-be, it's really true in any case. I learned from my pregnancy and that shaped how I then interacted with Daxton's doctors and with my next OB during my pregnancy with Tyler. I think most of the "good" doctors appreciate my stance; some other doctors, not so much. (I'll have to tell you guys one day about some of my least favorite former doctors. It's almost comical... now.)

I am now an educated consumer. I learned the hard way. I hope you don't have to.

1 comment:

Tiff-E said...

This blog sure hit home to me. I've ran through my head ten million times about all the possible ways my 23 week birth of twins could have been prevented. Why did I listen to my doctor when she blew off my awful lower back pain by saying "Get used to it, it's because you are having twins". I should have known better, but at the time I didn't. And the triage nurse who didn't check my cervix when she should've. We were back the next day and I was already 4cm and it was too late. I think I'll take your advice and use my blog to write about my story again too. Education and information is key. If I had only known then what I know now...