Wednesday, August 10, 2005


The perinatologist looks like an actor, but I can't remember his name or what he was in (I have terrible recall for things like movies and music). Cute, but definitely thinks he's brilliant. That wouldn't be such a bad thing if it were true.

At one point I was sitting through a story about how women in Afghanistan suffer through my sort of situation and even worse (maternal mortality is apparently a real problem in a war-torn country where there used to be, and some would argue there still is, a society that values the oppression of women...go figure).

The gist of the beginning of the visit was, "You did nothing wrong." Then we progressed to, "These things just happen." Unfortunately for the good doctor, I have spent hours researching (it's what I do), and I came armed with questions that made it clear these things may happen, but I believe they shouldn't. At that point I got the professional courtesy speech, "Even though we don't live in Afghanistan, even in our advanced medical society, these things get through, things are missed. You just have to accept it and move on from that point." ah-ha! There we have it! Anyone good with subtitles? Cause I think I'm reading, "Don't sue them...we have to keep malpractice rates down."

There is no way to tell if this will happen again. "It's a roll of the dice, but it is statistically unlikely" I explained how statistics don't mean much when you lose the odds game like we did. He suggested we need some perspective and should see a counselor. lol It wasn't quite that obvious...but I definitely got the feeling he felt we should be more comforted by the "likelihood" numbers instead of being so cautious.

He did suggest counseling at the end of our appointment "as a way to get back some perspective." I'm not exactly sure what perspective I'm supposed to "get back." I can pretty much read that I lost my baby because everyone missed the signs, though nobody has had the spine to say that outright. So my perspective now includes loser odds and distrust of doctors. Is this really a healthy perspective? I don't know. But it's the perspective I have now, and I think it's been hard earned. No amount of talking is going to return me to the safe place from which I approached baby-making before.

There are a few good things about this guy...

He called both our boys by their names.

He confirmed that I CAN read an autopsy correctly. Alex did die from a bacterial infection. The infection caused his organs to shut down and led to the hemorrhage in his brain. He died from "overwhelming sepsis." It was an ascending infection. The bacteria normally rides shotgun silently in my vagina. When Steve said he thought the amniotic sac protected the baby from that sort of thing, the doctor replied with, "Says who?" and a good snort and chortle. Great! Are we the ONLY people who misread those pregnancy and baby books?

It is "extremely rare" for this to happen and there is no way to predict if it will happen again. In fact, this generally happens in early pregnancy and women suffer miscarriage, not late in pregnancy where women have a stillbirth. (I love those "general" statements) But according to the doc, there is no reason, other than uncertainty and overwhelming fear, why we can't try to have another baby.

He started the consultation with, "You have to find a doctor who isn't seeing thirty patients in a day, a doctor who is going to aggressively monitor your next pregnancy." The plan is apparently to watch me like a hawk and deliver as soon as the baby can be delivered, thereby lessening the risk of bacterial infection. After telling him just a couple of the reasons I left U. Hosptial, he changed his tune to, "When you're pregnant, call ME and we'll set the plan in action." Somewhere during my horror story, he seemed to accept me as his patient (even though I wasn't entirely convinced that I wanted him as my doctor just yet).

He explained how HE would personally be involved in my care. He explained that the OBs there are right around the corner in the building and they can work very closely together. I like that I wouldn't have to have sixteen different appointments and the perinatologist could be available for my regular OB appointments.

He did acknowledge that the next pregnancy would be full of a BUNCH of mixed emotions and he would help the best he could to get us through them with whatever reassurances we need.

The bad things...

Like I said, he clearly thinks he's brilliant. Steve said it would be kind of funny when he finds out I'm a lawyer. hehe

He seemed to be anti-antibiotics for treating my type of infection. He said antibiotics simply kill off the weaker bacteria and allow the stronger bacteria to thrive. He did sort of catch himself and say, "Obviously that didn't happen with Alex." He said they did the "right thing" by not giving me anything for my "upper respiratory infection" when I was pregnant with Alex. I'm not sure if that was part of the professional courtesy of covering their asses or not. And I'm not sure how I feel about the prospect of presenting with symptoms of the same infection and my doctor not taking an aggressive treatment approach. He seemed to favor delivery over antibiotic therapy, and everything I've read indicates the antibiotics should be tried first while monitoring the baby for distress to determine if delivery is necessary. I think he thinks that because both my babies were so big (9lbs+), the next one could be delivered early without too many complications.

After our appointment, I told Steve that my first impression about my last OB had been to "run the other direction," but my impression of this guy was "meh." I don't have strong feelings one way or the other. Maybe that's because I have learned I can't trust doctors for one reason or another. I was reading a book last night (stopped by Barnes & Noble after the appointment) about Pregnancy After Loss. It had a line in it that said women should learn they are their own best health advocate. I TRULY believe this. I'm not only going to be an advocate for myself and my next baby, I'm going to be a nightmare of a patient.

He's just the specialist. While he'll be the first point of contact if/when we get pregnant again, we'll have a regular OB who is responsible for my care as well. I haven't met him/her, but I get a good feeling from the practice. Never once, during my visit did I feel like I was rushed or like I had to explain to someone why I was there. The assistant who took all our information to present to the doctor was very kind and understanding. I didn't feel like a nameless number. Even the receptionist was kind and didn't make me feel like I was inconveniencing her with my very existence.

The doc did remind me of mom at one point (Hi mom!). When we asked how long we should wait to try getting pregnant again, he looked at us, assessed my tears, and said, "Maybe early next year." Steve, who suddenly is putting RK Tucker's assertiveness training to use, said, "Well, we were thinking later this year, maybe October." The doc eyed me and asked, "You're how old?" (Good Lord, am I ready to be put out to pasture already?) I told him 33 and he said, "Yes, October would be fine. I wouldn't dilly-dally." Dilly-dally?!?! I laughed out loud...that is definitely something mom would say.

But my first thought about this perinatologist and future pregnancy is just "meh."

So now we have to decipher and decode and decide. My heart isn't ready just yet. Maybe in a few months. If it's all a game of chance, I have to be able to let go of the planning and just let it happen. I'm not there just yet.


Heather said...

I have been wondering how it went. To be honest, it doesn't sound like the "specialist" told you anything you didn't already know. You clearly have done your homework. You know you don't need to decide anything now, Kate. I can't imagine you will be ready to try again for a while. That is a huge decision. Just take care of you for now.

Lisa P. said...

I've been to that kind of doctor (in my case, it was a psychologist though, and on top of the brilliance factor was the fact that he was extremely good-looking and KNEW IT)... anyway, I agree with Heather's assessment that you know a lot. You also have a lot to get through, still, and you will know when you are feeling more ready to make the decision.


Julie said...

Meh. Not bad news, but not altogether a warm and fuzzy revelation either, huh. Does sound like a decent group to work with so far. Dillydally or not, you'll know when you're ready. And we'll be here for you.

Sweet Coalminer said...

I'm sorry he wasn't a knight in shining white coat. The medical profession needs more of those guys.

I know it's awful to say, but I was really glad to find out that my RE's wife had three miscarriages before carrying to term, and I think that made him a much more compassionate man. I mean, I was sorry for her, but I was grateful for the understanding. I wish you could find a doctor that had an inkling of what you've been through without bringing Afghanistan into it.

Julie said...

I wish you had more of a definate feeling of whether you want to go with this dr. or not, but at the same time, it's such a tough decision. I got lucky. I had an amazing dr when Caleb died, and I stuck with her when I got pg again. She knew my story and knew why I was scared out of my mind. She was also very obviously willing to do anything she could to ease my fears and get my baby here ALIVE.

You will know when the right time to try again is. For me, dh was out of the country for 6 months, and that was just the amount of time we really needed to know how badly we wanted another baby. Basically it seems like the NEED to get pg again have to outweigh the FEAR. Not saying the fear won't be there, but it gets to a point where you just have to try.


lauralu said...

where did my comment go?

what i way saying was something like, a "meh" sounds pretty good to me, given your overally feeling on doctors. i'm guessing he'd have to be crazy wonderful to elicit a "meh" from you.

and is he hot cute or just cute? because hot can be good. as i may have mentioned, my ob is kinda hot, and it helps a lot.

Jill said...

The whole appointment sounds like it was kind of surreal, dillydallying in Afghanistan and whatnot. But Laura has a point, and I am guessing his job was to dig himself out of a deep hole to get a 'meh':)

As for trying again, at least you know that physically, there are no impediments so it is simply(simple? did someone say simple??) a matter of waiting to be ready. Alex's death is still so recent, a little 'dillydallying' would be completely understandable.

Marlayna said...

Kate I am so impressed with how in-tune you are with your feelings. You are still in my thoughts and prayers daily. Hugs!

Lorem ipsum said...

My dad (age 64) also has 'dilly-dally' in his vocabulary. I always hated it, but as both of us get older I know one day it'll be one of the things I'll miss about him.