Thursday, February 21, 2013

Speaking Up.

Tulips just because... February 2013.

As seems to be the theme lately for my Thursday posts, a story on NPR this morning got me thinking.  And then it got me mad!  The story was about the rising health care costs in this country and how there is a campaign called Choosing Wisely that aims to educate both doctors and patients about ways to cut spending without diminishing quality of care.  Of course I found this topic interesting as I am an ICU and ER nurse by training but I also found it interesting from a patient perspective, namely as an obstetrics patient.

As I listened to the story this morning, I couldn't help but think about my own experience with my OB/GYN during my pregnancy.  I've mentioned before how I didn't have the easiest time conceiving Alice so, once I was finally pregnant, I wanted to do everything possible to keep her in there, happy and healthy.  And even though I am a medical professional, when it came to my own body being pregnant for the first time, I felt totally naive and uncertain.

Of course hindsight being what it is, I had a perfectly normal pregnancy.  I'd say even textbook except for that whole c-section part.  What is now so frustrating to look back on is my lack of voice concerning the way my OB/GYN took care of me.  Yes, Alice is here and she is healthy, but I believe my doctor did dozens of additional tests that racked up who-knows-how-much for our insurance company to pay.  I mean, she was doing blood test after blood test to check for completely obscure things that happen in less than one percent of the population!!  With nothing in my family history to give her any concern!!  Did she do it because she is a nervous-nellie?  Probably.  Or did she do it so that she could bill more and pad her pockets?!  Who knows, but I sure hope it isn't the latter.   

What is it about our culture that silences us when faced by a doctor concerning our bodies and our health?  I've always been an outspoken person (just ask my 4th grade teacher, Mrs. Folias) but when I timidly spoke up to my OB/GYN questioning why we were doing this test again she seemed to play into my fears and make the test sound completely and totally necessary.  And when the result would come back totally fine but on the low end of the normal range, she'd tell me she wanted to check the levels again to make sure they weren't dropping even though they had always been NORMAL!  I did finally get lippy with her near the end as I was so over being pregnant and so over being in her office every week but I always let her run that damn test again.

Because I didn't trust myself to speak up and be an advocate for my own health care.

I know this is a wordy post and I hope someone is still reading it.  How have your experiences been with health care?  After Alice was born, and as I laid in that hospital for those five long days, I finally had the last word with my OB/GYN... she came in to check on me and, after her exam, she told me that my hematocrit and hemoglobin levels were very low (think anemia) and I looked her square in the eye and said in my most sarcastic tone...

"Hmmmm... that's interesting, Dr.           .  Could it possibly be from you taking a vial of blood from me every goddamn week for the last 3 months?!"

I'm sure she chalked up my bitchy response to all those post-partum hormones.  And, needless to say, I've already found a very different and very laid-back OB/GYN for round two (don't get any ideas just yet!).         

Even the stems are pretty...

7 comments:

  1. Loved this post. Forgive what will probably be a long winded response. First of all your NPR stuff you listen to, is this literally on the radio or a podcast or what? I'm intersted.

    Also, as far as my own experience goes I'm a mother to 4 beautiful children. My first was c-section (and she was diagnosed with Prader-Willi Syndrome). I tell you about the PWS because I have a LOT of experience with doctors because of it. But mostly I was going to say that I think a great OB/GYN can be hard to find. After my first c section I REALLY wanted to try for a VBAC with my second baby. My OB during the course of my pregnancy visits changed my due date (moved up by 1 week) and didn't tell me (I found out off chance from a nurse). Then told me that he would only let me go one week late and then we'd schedule c section. Which translated to RIGHT ON TIME, with the pulling up of my due date. To this day I feel like he took that choice away from me because it was more convenient for him. I don't believe he was a big supporter of VBAC's. With that being said he delivered the next two of my babies, simply because at that point at least I had confidence that he was good at that part. To this day (my last baby was 2 years ago) it weighs heavy on my heart that I was "robbed" of that experience and desire. Add to that the fact that all my babies lost lots of weight right after they're born resulting in me being flat out BULLIED to not breastfeed and supplement with formula because of it. I dunno .. I've had some really bad experiences.

    With all that being said, my advice to you ... IF you are wanting to try for a VBAC be sure to find a doctor that is very suppportive of this. One who will work with you as a team to make that happen. Good luck!

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    1. I heard this story three times actually just on my regular morning NPR station. Luckily they replayed it a bunch as I only caught snippets of it each time over Alice's cries and squeals. ; )

      Thanks for sharing your story and I'm glad to know I'm not alone. I just still feel so duped by my MD and especially because I am a medical professional... I've never been one to shy away from discussing things for other people, namely my patients, so I'm not sure why I couldn't do it when it dealt with me? Despite my gut feeling that everything was okay, I just kept thinking, "what if she's right?'... So I let her keep doing all the tests under the sun.

      Anyway... The jury is still out on a VBAC for round two. The emergency c-section was pretty traumatic so I'm not sure I could go into a natural delivery in the right state of mind that all would be okay... We'll see. : )

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  2. I find health care and health insurance in this country to be extremely frustrating and nonsensical, but my own experience has been fairly decent. I delivered at Mt. Auburn with the midwives and they have a much less aggressive approach than I've seen with friends at other practices. A lot of my friends are actually surprised and concerned by the lack of ultrasounds I've had, but last time when I did encounter problems at the end things switched to high alert very quickly. I appreciated that balance. I was in the hospital for a couple weeks though, I can't even imagine what that bill was to the insurance company! Those charges are shocking.

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    1. I should've done a midwife for Alice and I often wonder if my delivery would've still ended in a c-section with a different practitioner. Who knows. Have you blogged about your birth experience with W? I'll have to do some searching on your blog, I guess. ; )

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  3. As someone who has experienced a home birth, a birth in a birthing center, and a hospital birth, I say midwives are the way to go. Their training is on the assumption that birth is a normal process, rather than a process that requires much medical intervention (but are fully equipped to deal with problems that may arise and do not have egos that limit them from asking for medical help if they need it-- which, by the way, is EXTREMELY uncommon in a normal, healthy pregnancy). I could go on and on. Basically, each experience was great, but what shocked me with my last pregnancy (I had to go to an OB for the first time just because of our physical location) was all the blood tests, ultrasounds, stress tests, etc. for a perfectly normal pregnancy. It was definitely overkill, and I did not enjoy going to see the OB.

    When I compare my experiences, I can say the following and it pretty much sums it up: going to a midwife, you are treated like a strong, capable, healthy woman. The expert of her own body. Going to a midwife, you are treated like a patient.

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    1. I meant to say "going to a doctor, you are treated like a patient." Oops!

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  4. Hello there. I understand you. I was also subjected to different tests by my OB/GYN. But I believe it was because she was just genuinely concerned and that she wanted to make sure my baby will be 100% fine. Anyway, your case is an example why it’s best to choose a doctor that you’ll be comfortable with. This is because communication between the doctor and the patient is crucial at all times.

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